(22-02-13) Three short perioperative infusions of n−3 PUFAs reduce systemic inflammation induced by cardiopulmonary bypass surgery:

Three short perioperative infusions of n−3 PUFAs reduce systemic inflammation induced by cardiopulmonary bypass surgery: a randomized controlled trial1,2,3
1. Mette M Berger,
2. Frederik Delodder,
3. Lucas Liaudet,
4. Piergiorgio Tozzi,
5. Juerg Schlaepfer,
6. Ren? L Chiolero, and
7. Luc Tappy
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Author Affiliations
1. 1From the Services of Adult Intensive Care Medicine (MMB, FD, LL, and RLC), Cardiovascular Surgery (PT), and Cardiology (JS), University Hospital - Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne (JS), and the University Physiology Institute, University of Lausanne, Lausanne, Switzerland (LT).
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Author Notes
? ↵2 Supported by the Fonds National Suisse de la Recherche Scientifique (grant 3200B0-113850). An additional unrestricted grant was offered by Fresenius Kabi AG Germany (products and laboratory determinations; to MMB and RLC).
? ↵3 Address correspondence to MM Berger, Service of Adult Intensive Care Medicine and Burns, Lausanne University Hospital, CHUV BH-08.612, Rue du Bugnon 46, CH?1011 Lausanne, Switzerland. E-mail: [email protected].
Abstract
Background: Fish oil (FO) has antiinflammatory effects, which might reduce systemic inflammation induced by a cardiopulmonary bypass (CPB).
Objective: We tested whether perioperative infusions of FO modify the cell membrane composition, inflammatory responses, and clinical course of patients undergoing elective coronary artery bypass surgery.
Design: A prospective randomized controlled trial was conducted in cardiac surgery patients who received 3 infusions of 0.2 g/kg FO emulsion or saline (control) 12 and 2 h before and immediately after surgery. Blood samples (7 time points) and an atrial biopsy (during surgery) were obtained to assess the membrane incorporation of PUFAs. Hemodynamic data, catecholamine requirements, and core temperatures were recorded at 10-min intervals; blood triglycerides, nonesterified fatty acids, glucose, lactate, inflammatory cytokines, and carboxyhemoglobin concentrations were measured at selected time points.
Results: Twenty-eight patients, with a mean ? SD age of 65.5 ? 9.9 y, were enrolled with no baseline differences between groups. Significant increases in platelet EPA (+0.86%; P= 0.0001) and DHA (+0.87%; P = 0.019) were observed after FO consumption compared with at baseline. Atrial tissue EPA concentrations were higher after FO than after control treatments (+0.5%; P < 0.0001). FO did not significantly alter core temperature but decreased the postoperative rise in IL-6 (P = 0.018). Plasma triglycerides increased transiently after each FO infusion. Plasma concentrations of glucose, lactate, and blood carboxyhemoglobin were lower in the FO than in the control group on the day after surgery. Arrhythmia incidence was low with no significant difference between groups. No adverse effect of FO was detected.
Conclusions: Perioperative FO infusions significantly increased PUFA concentrations in platelet and atrial tissue membranes within 12 h of the first FO administration and decreased biological and clinical signs of inflammation. These results suggest that perioperative FO may be beneficial in elective cardiac surgery with CPB. This trial was registered at clinicaltrials.gov as NCT0051617

Source: Am J Clin Nutr February 2013vol. 97 no. 2 246-254

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