The Effects of Fish Oil (EPA+DHA) on Chronic Ventilator Patients in a Long Term Acute Care Setting: A Randomized Control Trial
Year: 2011
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Purpose: The aim of this study was to determine whether patients in a long term acute care setting who received an enteral supplement containing EPA+DHA, would have a shorter weaning time from the ventilator, a decrease in length of hospital stay, decreased inflammatory markers, and number of infections from baseline to post-treatment compared to patients who received a placebo of normal saline solution.Methods: Nine participants who required mechanical ventilation and enteral nutrition support in a long term acute care hospital were randomized to either receive the treatment fish oil (n=5) or the placebo saline solution (n=4).Participants in the treatment group were given 8g fish oil per day through the enteral feeding tube for 14 days.Subjects randomized to the control group received a blinded saline solution for 14 days.All enteral supplement formulations were created by a certified pharmacist.Results: There were no significant differences between the treatment and control groups in regards to time to weaning, percent of days on the ventilator, or length of hospital stay.Inflammatory markers did not significantly decrease in either group from baseline to posttreatment.There was a trend towards a lower rate of infection in the treatment group compared to the control group, however these results were not significant.Conclusion: The results of this randomized double blind clinical trial suggest that adding fish oil (EPA/DHA) to enteral formulas does not result in reduced weaning time for patients on a ventilator, decreased length of hospital stay, or markers of inflammation.Additional research needs to be conducted with a larger group of participants to determine whether a high dose of EPA +DHA from fish oil can decrease inflammation in this specific population.iii Introduction-Content of the Review Acute lung injury (ALI) or acute respiratory distress syndrome (ARDS), are common disease states of patients who require ventilatory support in the intensive care unit setting (1).ALI and ARDS are acute life-threatening forms of hypoxic respiratory failure due to persistent pulmonary and systemic inflammation (2).Although many advances have been made in the pathophysiology of respiratory failure diseases, new developments in nutritional interventions to improved clinical outcomes in these patients have yet to be fully investigated and completely understood.Mechanically ventilated patients often suffer from respiratory distress, which is frequently caused by an inflammatory condition.These patients are generally are unable to meet the increased caloric needs from trauma and inflammation eating solely by mouth, therefore nutrition support therapy in this group of patients is extremely important (3).The polyunsaturated fatty acids, linoleic acid, an omega-6 fatty acid, and alpha linolenic acid, an omega-3 fatty acid, are the dietary elements supplemented into many enteral formulas given enterally to critically ill patients.Specifically, the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) derived from fish oil have been shown to have antiinflammatory effects in humans (1).Recently, several prospective, randomized, controlled studies have been conducted and have shown that the administration of an enteral nutrition formula rich in omega-3 fatty acids and elevated amounts of antioxidant vitamins to critically ill patients with lung injury and impaired oxygenation status produced significant improvements in oxygenation and lung compliance, and decreased length of ventilation and ICU stay (1, 4-6).Also, several studies have recently been conducted which confirm the beneficial effects of the addition of fish oil, gammalinolenic acid as borage oil, and elevated antioxidants added to enteral nutrition formulas on
Author: Jessica Harvey
Institution: University of Cincinnati
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2268615590