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Intravenous Lipid Emulsions to Deliver Bioactive Omega-3 Fatty Acids for Improved Patient Outcomes

1
Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
2
NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
Mar. Drugs 2019, 17(5), 274; https://doi.org/10.3390/md17050274
Received: 13 March 2019 / Revised: 23 April 2019 / Accepted: 6 May 2019 / Published: 8 May 2019
(This article belongs to the Special Issue Marine Anti-inflammatory Agents)
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Abstract

Lipids used in intravenous nutrition support (i.e., parenteral nutrition) provide energy, building blocks, and essential fatty acids. These lipids are included as emulsions since they need to be soluble in an aqueous environment. Fish oil is a source of bioactive omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid). Lipid emulsions, including fish oil, have been used for parenteral nutrition for adult patients post-surgery (mainly gastrointestinal). This has been associated with alterations in biomarkers of inflammation and immune defense, and in some studies, a reduction in length of intensive care unit and hospital stay. These benefits, along with a reduction in infections, are emphasized through recent meta-analyses. Perioperative administration of fish oil may be superior to postoperative administration, but this requires further exploration. Parenteral fish oil has been used in critically ill adult patients. Here, the influence on inflammatory processes, immune function, and clinical endpoints is less clear. However, some studies found reduced inflammation, improved gas exchange, and shorter length of hospital stay in critically ill patients if they received fish oil. Meta-analyses do not present a consistent picture but are limited by the small number and size of studies. More and better trials are needed in patient groups in which parenteral nutrition is used and where fish oil, as a source of bioactive omega-3 fatty acids, may offer benefits. View Full-Text
Keywords: fish oil; omega-3; eicosapentaenoic acid; docosahexaenoic acid; inflammation; eicosanoid; cytokine; surgery; critical illness; parenteral nutrition fish oil; omega-3; eicosapentaenoic acid; docosahexaenoic acid; inflammation; eicosanoid; cytokine; surgery; critical illness; parenteral nutrition
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Calder, P.C. Intravenous Lipid Emulsions to Deliver Bioactive Omega-3 Fatty Acids for Improved Patient Outcomes. Mar. Drugs 2019, 17, 274.

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