Adjuvant Treatment with Fish Oil-based Lipid Emulsion Infusions in Critically Ill Patients with Severe Sepsis

• Main Authors: Boon-Siang Khor, 許文祥
• Other Authors: Liang-Shun Wang
• Format: Others
• Language: zh-TW
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/02531854046865234258

碩士 === 國立陽明大學 === 急重症醫學研究所 === 99 === Purpose: The present study aimed to determine the clinical benefits to patients critically ill with severe sepsis of receiving parenteral fish oil-based lipid emulsion (FOBLE) as adjuvant treatment. Design: A prospective double-blind, randomized and placebo-controlled clinical trial study. Materials and Methods: Between April 2008 and March 2009, patients admitted to the 38-bed general ICU of a primary and referral hospital with a main diagnosis of severe sepsis were enrolled in the study. The enrolled patients were randomized to receive either supplementation of FOBLE (10 % Omegaven, Fresenius-Kabi, Bad Homburg, Germany) as study or placebo (0.9% Normal Saline) as control via a central venous catheter within 24 hours after ICU admission, 100 ml daily for 5 days. The Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE III, and Simplified Acute Physiology Score (SAP) II as well as TNF-α and procalcitonin were determined from data obtained at baseline, and following on days 1, 3, 5 and 7. Patients will be followed for 28 days after the start of the infusion or until death. Results: Fourteen patients were randomly assigned to study group and a similar number were placed in control group. The study group showed significant score reduction for APACHE II on days 3 (P = 0.004), 5 (P = 0.032) and 7 (P = 0.03) together with APACHE III (P = 0.028) and SAP II (P = 0.019) on day 7. The serum procalcitonin level was significantly decreased in the study group on days 3 (P = 0.018), 5 (P = 0.011) and 7 (P = 0.028). However, the serum TNF-α level, length of ICU and hospital stay showed no statistical difference when the groups were compared. Conclusions: Adjuvant treatment with FOBLE for critically ill patients with severe sepsis is a probably safe and helpful method of reducing the clinical severity of the disease.