Fish oil-containing lipid emulsions in patients with sepsis.docVIP

Mayer and Seeger Critical Care 2010,14:128 /content/14/2/128 COMMENTARY Fish oil-containing lipid emulsions in patients with sepsis Konstantin Mayer* and Werner Seeger See related research by Barbosa et al., /content/14/1/R5 Use of SO-based lipid emulsions increases availability Abstract of free arachidonic acid, the precursor fatty acid of lipid Lipid emulsions based on soybean oil have been an integral part of parenteral nutrition supplying n-6 mediators in septic patients [2]. A deterioration of the PaO /FiO ratio has been attributed to fast infusion 2 2 fatty acids, with possible negative e?ects in critically ill patients. Newer lipid emulsions supply less n-6 fatty acids. In addition, ?sh oil-based lipids may be included in the lipid component of parenteral nutrition. While clinical bene?ts of lipid emulsions with a reduced fraction in n-6 lipids and the addition of ?sh oil have been described in postoperative patients, data are less clear in critically ill or septic patients. Recent data suggest that bene?cial e?ects may be achieved when used early but clearly more data are needed to come to a de?nitive conclusion. The present commentary will highlight current data in critically ill and septic patients and the use of ?sh oil as a part of parenteral nutrition. (6 hours) instead of slow infusion (24 hours) of a SO- based lipid emulsion in patients with acute respiratory distress syndrome due to generation of arachidonic acid- derived prostaglandins and thromboxane [3]. In a simpli? ed model, sepsis may be described as starting with a hyperin? ammatory phase followed by a phase of immune suppression. When used early in septic patients, SO-based lipid emulsions have been shown to increase ex vivo cytokine generation in a small st ese lipid emulsions also led to an increased apoptosis of splenic lymphocytes in a murine model, amplifying this key feature of immune suppres sio