The role of lipid emulsions containing omega-3 fatty acids for medical and surgical critical care patients

IF 8.8 1区医学 Q1 CRITICAL CARE MEDICINE

Critical Care Pub Date : 2024-08-12 DOI:10.1186/s13054-024-05053-4

Christian Stoppe, Robert G. Martindale, Stanislaw Klek, Philip C. Calder, Paul E. Wischmeyer, Jayshil J. Patel

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Abstract

In critical illness the regulation of inflammation and oxidative stress can improve patient outcomes, and thus omega-3 polyunsaturated fatty acids (PUFAs) have been used as part of parenteral nutrition (PN) owing to their potential anti-inflammatory effects. The international lipids in PN Summit, encompassed discussions and the production of consensus guidelines concerning PN intravenous lipid emulsion (ILE) use in critical care. The Lipid Summit participants agreed that the inclusion of fish oil in ILEs is associated with meaningful clinical benefits without signals of harm, based on a strong biological rationale and current clinical evidence. Decisions concerning ILE choice should be made based on current evidence, thus addressing clinical requirements for guidance, particularly as further definitive evidence seems unlikely to occur. In addition, a future of individualized ICU care is envisioned, yielding better clinical outcomes. This approach will require the greater use of intelligent study designs incorporating the use of biomarkers of omega-3 derivatives, inflammatory-resolving processes, and/or muscle protein breakdown.

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含欧米茄-3 脂肪酸的脂质乳剂对内科和外科重症监护患者的作用

在危重病中，调节炎症和氧化应激可改善患者的预后，因此，ω-3 多不饱和脂肪酸 (PUFA) 因其潜在的抗炎作用而被用作肠外营养 (PN) 的一部分。国际肠外营养脂质峰会就危重症护理中肠外营养静脉注射脂质乳剂 (ILE) 的使用进行了讨论并制定了共识指南。脂质峰会的与会者一致认为，在 ILE 中加入鱼油可带来显著的临床益处，且不会造成危害，这是基于强大的生物学原理和当前的临床证据。有关 ILE 选择的决定应基于当前的证据，从而满足临床对指导的要求，尤其是在似乎不太可能出现进一步明确证据的情况下。此外，未来的重症监护室护理有望实现个体化，从而取得更好的临床疗效。这种方法将需要更多地使用智能研究设计，并结合使用欧米伽-3 衍生物、炎症分解过程和/或肌肉蛋白质分解的生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Critical Care 医学-危重病医学

CiteScore

20.60

自引率

3.30%

发文量

348

审稿时长

1.5 months

期刊介绍： Critical Care is an esteemed international medical journal that undergoes a rigorous peer-review process to maintain its high quality standards. Its primary objective is to enhance the healthcare services offered to critically ill patients. To achieve this, the journal focuses on gathering, exchanging, disseminating, and endorsing evidence-based information that is highly relevant to intensivists. By doing so, Critical Care seeks to provide a thorough and inclusive examination of the intensive care field.