Early Fish Oil Supplementation and Organ Failure in Patients With Septic Shock From Abdominal Infections: A Propensity-Matched Cohort Study

JPEN J Parenter Enteral Nutr. Jul-Aug 2010;34(4):431-7. doi: 10.1177/0148607110362764.

Abstract

Background: Fish oil (FO) has immunomodulating effects and may improve organ function and outcome in critically ill patients. This retrospective, propensity-matched cohort study investigates the effects of early intravenous FO supplementation on organ failure in patients with septic shock from abdominal infection.

Methods: A medical database was retrospectively searched for critically ill patients admitted because of septic shock from abdominal infection (n = 194). Demographic, clinical, and laboratory data; FO supplementation (10 g/d) (n = 42); rate, degree, and number of organ failures assessed by the Sequential Organ Failure Assessment (SOFA) score; and secondary outcome variables were recorded. A propensity score-based model was used to establish 2 comparable groups (FO, n = 29; control, n = 29). Mann-Whitney rank sum test, Fisher exact test, and logistic regression analyses were used to compare variables between groups.

Results: There were no differences in the rate of single organ failures, the maximum SOFA score (median [interquartile range (IQR)], 12 [8-15] vs 11 [9-14]; P = .99), or the number of organ failures (median [IQR], 2 [1-3] vs 2 [1-3]; P = .54] between patients receiving FO supplementation and those not receiving supplementation. There were no group differences in the maximum C-reactive protein levels (P = .1), duration of mechanical ventilation (P = .65) or hemofiltration (P = .21), intensive care unit-acquired infections, intensive care unit length of stay (P = .59), and intensive care unit (P = 1) or hospital mortality (P = 1).

Conclusions: Early intravenous FO may not decrease the number and degree of organ failures in patients with septic shock from abdominal infection. Future trials are needed before FO supplementation in septic shock from abdominal infection can be recommended.

MeSH terms

  • Abdomen
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Cohort Studies
  • Critical Illness
  • Dietary Fats / administration & dosage
  • Dietary Supplements*
  • Fat Emulsions, Intravenous / administration & dosage
  • Fatty Acids, Omega-3 / pharmacology
  • Fatty Acids, Omega-3 / therapeutic use*
  • Female
  • Fish Oils / pharmacology
  • Fish Oils / therapeutic use*
  • Humans
  • Immunologic Factors
  • Infections / blood
  • Infections / complications
  • Infections / drug therapy*
  • Logistic Models
  • Male
  • Multiple Organ Failure / epidemiology
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / prevention & control*
  • Parenteral Nutrition
  • Propensity Score
  • Retrospective Studies
  • Shock, Septic / blood
  • Shock, Septic / drug therapy*
  • Shock, Septic / etiology
  • Statistics, Nonparametric
  • Treatment Outcome

Substances

  • Dietary Fats
  • Fat Emulsions, Intravenous
  • Fatty Acids, Omega-3
  • Fish Oils
  • Immunologic Factors