scholarly journals Pilot, Randomized, Double-blind Trial To Study The Effect Of Parenteral Supplementation With Fish Oil Emulsion In The Nutritional Support Of Esophagectomized Patients

2019 ◽  
Author(s):  
Ana Suárez-Lledó ◽  
Elisabet Leiva Badosa ◽  
Josep M Llop Talaveron ◽  
Monica Fernandez Alvarez ◽  
Leandre Farran Teixidor ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Enteral Nutrition ◽  
Fish Oil ◽  
Nutritional Support ◽  
Lipid Emulsion ◽  
Nutrition Support ◽  
High Morbidity ◽  
Lipid Emulsions ◽  
Double Blind ◽  
Enteral Nutrition Support

Abstract Background Esophagectomy is a major surgical procedure with a high degree of catabolic and postsurgical inflammatory response that conditions a high morbidity and a significant mortality. Enteral administration of ω-3 fatty acids has been seen to be effective although its use is limited due to tolerance. There are few clinical trials with ω-3 fatty acids parenterally in these patients, so we propose to investigate the effect of combining a lipid emulsion rich in fish oil with the standard enteral nutrition support. Methods Prospective, single-center, randomized, double-blind study in patients diagnosed with esophageal cancer and after esophagectomy treated with a lipid emulsion rich in ω-3 fatty acid emulsion or a mixture of ω-6 long chain triglycerides (LCT) / short chain triglycerides (MCT) 50%. After surgery, these emulsions will be added to the standard nutritional support in continuous infusion until complete 5 days of treatment. Patients will be randomized 1:1:1 in Group A 0,4g/kg/day of lipid emulsion rich in fish oil; Group B 0,8g/kg/day of lipid emulsion rich in fish oil and Group C 0,8g/kg/day of LCT/MCT emulsion. The main objective is to determine whether the administration for 5 days of intravenous lipid emulsions rich in ω-3 fatty acids in patients after esophagectomy is effective in normalizing the interleukin-6 (IL6) compared with LCT/MCT emulsions, and if 0,8 g/kg/day dose is more effective than 0,4g/kg/day. Secondary outcomes include other inflammatory markers as C reactive protein (CRP), tumor necrosis factor alpha (TNF-a) and interleukin-10 (IL-10), and parameters of morbidity, safety, nutrition and mortality. Samples will be collected at the moment of surgery indication and on days 0, 1, 3, 5 and 21 to determine inflammatory, nutritional, hepatic and security parameters. In addition, clinical follow-up throughout the hospital stay and up to one year after surgery. Discussion There are few studies of fatty acids ω-3 administered via parenteral in oesophagectomized patients. This study proposes to investigate the effect of combining fish-oil lipid emulsions administered via parenteral with enteral nutrition support, implying benefits such as: fast incorporation of lipids to the cellular membranes and to the inflammatory cascade, and the use of only one pharmaconutrient.

Parenteral and Enteral Nutrition Support Service (NSS): A Multidisciplinary Approach in a Community Hospital

1997 ◽  
Vol 10 (6) ◽  
pp. 426-443
Author(s):  
Saifi Vohra ◽  
Ying Wang
Keyword(s):  
Enteral Nutrition ◽  
Multidisciplinary Team ◽  
Nutritional Support ◽  
Multidisciplinary Approach ◽  
Community Hospital ◽  
Support Service ◽  
Nutrition Support ◽  
Maximal Response ◽  
Registered Dietitians ◽  
Enteral Nutrition Support

Nutritional support for hospitalized patients is recognized as an important medical therapy. Appropriate nutritional support can promote the patient's maximal response to medications, resistance to sepsis, and recovery from injury. Nutritional support service can be performed by a multidisciplinary team consisting of physicians, registered dietitians, registered nurses, and registered pharmacists. A comprehensive protocol has been developed to guide the nutritional support service. This review summarizes the guidelines of our protocol.

scholarly journals Parenteral nutrition providing a restricted amount of linoleic acid in severely burned patients: a randomised double-blind study of an olive oil-based lipid emulsion v. medium/long-chain triacylglycerols

2005 ◽  
Vol 94 (2) ◽  
pp. 221-230 ◽  
Author(s):  
A. García-de-Lorenzo ◽  
R. Denia ◽  
P. Atlan ◽  
S. Martinez-Ratero ◽  
A. Le Brun ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Linoleic Acid ◽  
Liver Function ◽  
Parenteral Nutrition ◽  
Lipid Emulsion ◽  
Liver Function Tests ◽  
Lipid Emulsions ◽  
Double Blind ◽  
Long Chain

It has been claimed that lipid emulsions with a restricted linoleic acid content can improve the safety of total parenteral nutrition (TPN). The tolerability of TPN and its effects on the metabolism of fatty acids were assessed in this prospective, double-blind, randomised study comparing an olive/soyabean oil long-chain triacylglycerol (LCT) with a medium-chain triacylglycerol (MCT)/LCT; 50:50 (w) based lipid emulsion in two groups (O and M, respectively; eleven per group) of severely burned patients. After resuscitation (48–72 h), patients received TPN providing 147 kJ/kg per d (35 kcal/kg per d) with fat (1·3 g/kg per d) for 6 d Plasma fatty acids, laboratory parameters including liver function tests, and plasma cytokines were assessed before and after TPN. Adverse events encountered during TPN and the clinical outcomes of patients within the subsequent 6 months were recorded. With both lipid emulsions, the conversion of linoleic acid in its higher derivatives (di-homo-γ-linolenic acid) improved and essential fatty acid deficiency did not appear. Abnormalities of liver function tests occurred more frequently in the M (nine) than in the O (three) group (P=0·04, Suissa–Shuster test). Seven patients (four from group O and three from group M) died as a consequence of severe sepsis 3–37 d after completion of the 6 d TPN period. When compared with the surviving patients, those who died were older (P=0·01) and hyperglycaemic at baseline (P<0·001), and their plasma IL-6 levels continued to increase (P<0·04). Although fatty acid metabolism and TPN tolerability were similar with both lipid emulsions, the preservation of liver function noted with the use of the olive oil-based lipid emulsions deserves confirmation.

scholarly journals Impact of Propofol Sedation upon Caloric Overfeeding and Protein Inadequacy in Critically Ill Patients Receiving Nutrition Support

Pharmacy ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 121
Author(s):  
Roland N. Dickerson ◽  
Christopher T. Buckley
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Critically Ill Patients ◽  
Protein Intake ◽  
Lipid Emulsion ◽  
Caloric Intake ◽  
Nutrition Therapy ◽  
Nutrition Support

Propofol, a commonly used sedative in the intensive care unit, is formulated in a 10% lipid emulsion that contributes 1.1 kcals per mL. As a result, propofol can significantly contribute to caloric intake and can potentially result in complications of overfeeding for patients who receive concurrent enteral or parenteral nutrition therapy. In order to avoid potential overfeeding, some clinicians have empirically decreased the infusion rate of the nutrition therapy, which also may have detrimental effects since protein intake may be inadequate. The purpose of this review is to examine the current literature regarding these issues and provide some practical suggestions on how to restrict caloric intake to avoid overfeeding and simultaneously enhance protein intake for patients who receive either parenteral or enteral nutrition for those patients receiving concurrent propofol therapy.

Unintended Adverse Effects of Enteral Nutrition Support

2016 ◽  
Vol 62 (1) ◽  
pp. 169-173 ◽  
Author(s):  
Karoline Pahsini ◽  
Sabine Marinschek ◽  
Zahra Khan ◽  
Marguerite Dunitz-Scheer ◽  
Peter Jaron Scheer
Keyword(s):  
Adverse Effects ◽  
Enteral Nutrition ◽  
Nutrition Support ◽  
Enteral Nutrition Support

Omega-3 Levels and Nicotine Dependence: A Cross-Sectional Study and Clinical Trial

2015 ◽  
Vol 22 (3) ◽  
pp. 153-162 ◽  
Author(s):  
Juçara X. Zaparoli ◽  
Eduardo K. Sugawara ◽  
Altay A.L. de Souza ◽  
Sérgio Tufik ◽  
José Carlos F. Galduróz
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Fish Oil ◽  
Nicotine Dependence ◽  
Cross Sectional Study ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Double Blind ◽  
Cross Sectional ◽  
Omega 3 Fatty Acid

Background: High oxidative stress, which is caused by smoking, can alter omega-3 fatty acid concentrations. Since omega-3 fatty acids play a role in dopaminergic neurotransmission related to dependence, it is important to understand their effects on nicotine dependence. Methods: This research comprised 2 studies. The first one consisted of a cross-sectional evaluation, in which the levels of the most important omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), were compared between smokers and non-smokers in a sample of 171 individuals; of them, 120 were smokers and 51 were non-smokers. The other study was a clinical, double-blind, randomized, placebo controlled, in which 63 smokers received daily treatment with capsules of fish oil (a source of omega-3/3 g/day) or mineral oil (used as placebo, also 3 g/day), taken 3 times a day for 90 days. Each fish oil capsules contained approximately 210.99 mg EPA and 129.84 mg of DHA. The outcome was evaluated by means of psychometric and biological measures as well as self-reports of tobacco use. The evaluations were carried out at the beginning of treatment and once a month thereafter (total of 4 times). Outcomes: The omega-3 fatty acid lipid profile showed that smokers present lower concentrations of DHA. After treatment, the omega-3 group showed a significant reduction in their levels of dependence. Interpretation: Smokers showed lower peripheral levels of omega-3, and treatment with the most important omega-3 fatty acids brought about a reduction in nicotine dependence.

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