Fish Oil Substituted for Soybean Oil Heals Liver Complication
Bottomline: Critically ill children depending on life-sustaining intravenous feeding, improved when fish-oil replaced the conventional soybean oil emulsion. Pediatrics 2008 121 (March): e678-e686.
Background: In the USA, the standard fat emulsion used to feed critically ill patients is soybean oil, which is high in omega-6 fatty acids. Liver disease is a complication that may develop from using life-sustaining nutrition infusion (parenteral nutrition), especially in children, where it can be fatal. Some researchers believe that the standard use of soybean oil may be the cause of this complication because of its proinflammatory omega-6 fats.
Summary: Parenteral nutrition-dependent children, who developed, cholestasis, a liver condition indicated by a serum bilirubin level of >2 mg/dL), had their conventional soy-oil emulsions discontinued and replaced by a fish-oil–based emulsion. The fish-oil group experienced reversal of their cholestasis faster than subjects in the soybean-oil group. By 9 weeks the fish oil group reversed the cholestasis, compared to 44 weeks in the comparison cohort group. The amount of time that it takes to heal the liver is significant significant, because once liver disease has developed, the death rate can be as high as 100% in those children unable to be weaned off parenteral nutrition within a year of diagnosis. It is not clear if these benefits are because of the absence of soybean oil or because of the presence of fish oil.
Study Quote: "Our results suggest that fish-oil–based emulsions may reverse PNALD when used in place of standard soybean emulsions."
Comment: This study adds to a growing body of research that the standard use of soybean oil for patients who are unable to eat or are unable to use their GI tract, might hamper patient recovery because it contains a high level of omega-6 fat (Koch & Heller, 2005 and Mayer & Seeger, 2008).
Links:
Gura, K et al.
Safety and Efficacy of a Fish-Oil-Based Fat Emulsion in the Treatment of Parenteral Nutrition-Associated Liver Disease.Pediatrics 2008 121: e678-e686 (free full text).
T . Koch , A . Heller
Benefits of omega-3 fatty acids in parenteral nutrition.
Clinical Nutrition Supplements ,Volume 1 ,Issue 3 ,Pages 17 - 24
Background: In the USA, the standard fat emulsion used to feed critically ill patients is soybean oil, which is high in omega-6 fatty acids. Liver disease is a complication that may develop from using life-sustaining nutrition infusion (parenteral nutrition), especially in children, where it can be fatal. Some researchers believe that the standard use of soybean oil may be the cause of this complication because of its proinflammatory omega-6 fats.
Summary: Parenteral nutrition-dependent children, who developed, cholestasis, a liver condition indicated by a serum bilirubin level of >2 mg/dL), had their conventional soy-oil emulsions discontinued and replaced by a fish-oil–based emulsion. The fish-oil group experienced reversal of their cholestasis faster than subjects in the soybean-oil group. By 9 weeks the fish oil group reversed the cholestasis, compared to 44 weeks in the comparison cohort group. The amount of time that it takes to heal the liver is significant significant, because once liver disease has developed, the death rate can be as high as 100% in those children unable to be weaned off parenteral nutrition within a year of diagnosis. It is not clear if these benefits are because of the absence of soybean oil or because of the presence of fish oil.
Study Quote: "Our results suggest that fish-oil–based emulsions may reverse PNALD when used in place of standard soybean emulsions."
Comment: This study adds to a growing body of research that the standard use of soybean oil for patients who are unable to eat or are unable to use their GI tract, might hamper patient recovery because it contains a high level of omega-6 fat (Koch & Heller, 2005 and Mayer & Seeger, 2008).
Links:
Gura, K et al.
Safety and Efficacy of a Fish-Oil-Based Fat Emulsion in the Treatment of Parenteral Nutrition-Associated Liver Disease.Pediatrics 2008 121: e678-e686 (free full text).
T . Koch , A . Heller
Benefits of omega-3 fatty acids in parenteral nutrition.
Clinical Nutrition Supplements ,Volume 1 ,Issue 3 ,Pages 17 - 24
Mayer K, Seeger W.
Fish oil in critical illness.
Curr Opin Clin Nutr Metab Care. 2008 Mar;11(2):121-7.
Posted by Evelyn Tribole MSRD at September 23, 2008 9:45 AM 
Categories: Critical Care, fish oil, Intervention Study (Low Omega-6), 2008 Studies, TPN, Full Text Studies-FREE
Categories: Critical Care, fish oil, Intervention Study (Low Omega-6), 2008 Studies, TPN, Full Text Studies-FREE
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