Infection often causes sepsis, which has a high mortality and morbidity rate, especially in critically ill patients. The mortality rate can reach 17%, and around 5.3 million people die from sepsis every year.
An estimated $20bn is spent on treating sepsis sufferers annually, and there is a need to find novel approaches to improve clinical outcomes.
In particular, antioxidant and anti-inflammatory treatment have been identified as key targets, as sepsis induces systemic inflammatory response syndrome (SIRS).
As such, researchers at Fudan Univerisity conducted a prospective, non-randomised observational clinical study of 112 patients with sepsis in the surgical ICU of a tertiary referral hospital between March 2013 and May 2015.
They divided the patients into one control group receiving standard sepsis treatment (based on existing guidelines), and one study group receiving parenteral nutrition containing fish oil.
They then observed that in the study group, there as a 20% reduction in all-cause mortality, whereas the reduction was only 10% in the control group.
In addition, those in the study group tended to stay in the ICU for a shorter period than those in the control group.
However, there was no statistical difference between the two groups when it came to tumour necrosis factor-alpha (TNF-α) and procalcitonin (PCT) levels, 28-day mortality, the length of hospital stay, or the duration of mechanical ventilation required.
The patients also did not exhibit any adverse drug-related effects during the study.
Considerations and conclusions
The researchers stated that the study's limitations included its relatively small sample size, and imbalanced cases in both groups may have influenced the accuracy of their analyses.
They added that in future studies, glucocorticoids and other anti-inflammatory drugs should be taken into account, and the dosage of fish oil should be standardised.
In conclusion, they wrote: "Parenteral nutrition with fish oil is probably safe and may improve clinical outcome in critical ill patients with sepsis.
"This prospective observational study showed that parenteral fish oil was relevant to the reduction of all-cause mortality…and tends to decrease the length of ICU stay in critically illness patients with sepsis.
"Fish oil might be safe and have the ability to improve the clinical outcome in patients with sepsis."
Source: Asia Pacific Journal of Clinical Nutrition
"The efficacy of parenteral fish oil in critical illness patients with sepsis: a prospective, non-randomized, observational study"
Authors: Wen-si Li, et al.