Patients admitted to the ICU will usually experience inflammation, hypercatabolic states, and the production of endogenous compounds. This results in loss of energy, protein, and micronutrients with negative consequences for the immune system and gut defense, diaphragmatic contractility, and delayed wound healing. Nutritional support in the ICU through enteral or parenteral nutrition can prevent a negative energy balance.
Based on the ESPEN guidelines on nutrition for critically ill patients, medical nutrition therapy can be given to patients in the ICU for more than 48 hours.
The type of nutrition given to patients treated in the ICU is still a lot of debate, including the administration of omega 3. Some literature states that enteral and parenteral nutrition enriched with omega 3 has a beneficial effect on critically ill patients.
The following is a study that aims to assess the effect of a combination of enteral and parenteral nutrition enriched with omega-3 on the blood oxygenation of patients in the ICU. The design and method were single-center, prospective, randomized, double-blind, with a total of 100 ICU patients and an age range of 18-85 years using mechanical ventilation. Subjects were randomly divided into the omega-3 group (n=50) and the control group without omega-3 (n=50). It was given for 28 days. The primary parameter assessed was PaO2/FiO2 from the first to the fourth day. While the secondary parameters were pulmonary function, complications in the ICU, length of stay in the hospital, days free of care in the ICU/ventilator/sedation/catecholamines, mortality, erythrocyte fatty acid composition, and inflammation parameters.
The results showed that blood oxygenation (∆PaO2/FiO2 from day one to day four: -1.3 ± 83.7, n=42, and 13.3 ± 86.1, n=39, in the omega-3 group and control without omega-3, p=0.7795) and other lung functions were not different between the two groups, but for days free of catecholamine therapy were significantly higher in the omega-3 group.
Conclusion:
Administration of a combination of enteral and parenteral nutrition supplemented with omega-3 can not improve lung function but can stop catecholamine therapy more quickly. In addition, parenteral nutritional supplementation can achieve more significant energy targets.
Image: Illustration (www.pexels.com)
Reference:
Singer P, Bendavid I, Mesilati-Stahy R, Green P, Rigler M, Lev S, et al. Enteral and supplemental parenteral nutrition enriched with omega-3 polyunsaturated fatty acids in intensive care patients - A randomized, controlled, double-blind clinical trial. Clinical Nutrition 2021;40:2544-54.
