Clinic Study On The Effect Of ω-3 Fatty Acids On Critical Patients With Systemic Inflammatory Response Syndrome

Systemic inflammatory response syndrome was triggered by some stress like infection, trauma, major surgery and shock in the critical patients of ICU. However, when SIRS ignoranced or improper treated, the patients were suffered from septic shock and multiple organ dysfunction syndrome (MODS) which was one of the causes of death to critically ill patients .It was reported that the mortality of sepsis reached 18% to 19%. Worse still, the mortality of severe sepsis ranged from 40% to 50%, and its incidence increased at the rate of 1.5% to 9% per year. The proposition of SIRS, as a new concept, but not a new disease, was the ground of thorough understanding of infection, inflammation and the mechanism of serious illness'occurrence and deterioration. MODS was one of the major cause of death of ICU patients. In modern medical perspective, SIRS was the foundation and the inevitable process of second MODS. Consequently, the reduction in severe systemic inflammatory reaction of critically ill patients at early stage was important to preventing MODS.Intermediate metabolism (arachidonic acid) of the traditional fat emulsion (ω-6 PUFA) was affected by Fish oil (ω-3 polyunsaturated fatty acids,ω-3 PUFA) through the way of competition, resulting in low-efficient"3"series of prostaglandins and"5"series of leukotrienes, the decreasing production of"2"series of the prostate such as PGE2, PGI2, TXA2 and the increasing production of"3"series of prostaglandins such as PGE3, PGI3, TXA3. Its metabolites, eicosane acid (EPA)) and docosahexenoic acid (DHA), which have mild immunosuppression, can inhibit the effects of inflammation, help to lower excessive inflammatory response and promote macrophage phagocytic functions, thus improve immune function.ω-3 PUFA, as a specific immune nutrient, can regulate the synthesis of lipid media, release cytokine, activate leukocyte activity and endothelial cell, subsequently, inhibit the excessive inflammatory response of the body and play the combined roles of nutrition and pharmacology in the cases of infection, trauma and the like.The benefit impacts ofω-3 PUFA on patients'severe systemic inflammatory response were evaluated by the effect ofω-3 PUFA on APACHEⅡscore, C-reactive protein (CRP) and cytokines of critical patients.ObjectivesThe research was in order to study clinical effects ofω-3 fatty acids (PUFA) in treatment of critical patients with systemic inflammatory response syndrome in ICU and its influence on inflammatory cytokine by changing of APACHEⅡscore, CRP, TNF-α, IL-1, IL-6, IL-8, ALT, AST and TBIL before and after the treatment ofω-3 fatty acids (PUFA),MethodsSeventy-six critically ill patients with systemic inflammatory response syndrome were randomly divided into control group (n=37) and trial group (n=39).Provided with the same routine treatment, the control group's patients received 20% Fat Emulsion and the trial group's patients received 20% Fat Emulsion supplement withω-3 fatty acids. Both groups have been treated for seven days. Acute physiology and chronic health evaluationⅡ(APACHEⅡ) score was marked and C- reactive protein, Tumor necrosis factor-α, IL-1, IL-6, IL-8, Alanine aminotransferase (ALT), Nmda transaminase (AST) and Total bilirubin (TBIL) were tested respectively before and after treatment between groups.ResultsCompared with pre-treatment, APACHEⅡscore, CRP, TNF-α, IL-1, IL-6 and IL-8 of trial group decrease significantly after treatment, as well as the index of ALT ,AST and TBIL(P<0.05). Compared with the control group, APACHEⅡscore of trial group falls sharply after treatment(P<0.05). The same is true of CRP, TNF-α, IL-1, IL-6, IL-8 as well as ALT ,AST and TBIL(P<0.05).Conclusion1.ω-3 fatty acids can alleviate the acute inflammatory response of critical patients.2.ω-3 fatty acids can promote liver function and improve the prognosis of patients.