Influence of a total parenteral nutrition enriched with omega-3 fatty acids on leukotriene synthesis of peripheral leukocytes and systemic cytokine levels in patients with major surgery. Fish Oil Supplementation Improves Neutrophil Function During Cancer Chemotherapy Prospective double-blind randomized study on the efficacy and safety of an n-3 fatty acid enriched intravenous fat emulsion in postsurgical gastric and colorectal cancer patients Randomized clinical trial of intravenous soybean oil alone versus soybean oil plus fish oil emulsion after gastrointestinal cancer surgery A prospective, randomized, controlled study of ω-3 fish oil fat emulsion-based parenteral nutrition for patients following surgical resection of gastric tumors Effect of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. Enteral Nutrition in ARDS Study Group. The effect of an oral nutritional supplement enriched with fish oil on weight-loss in patients with pancreatic cancer Immunomodulation by perioperative administration of n-3 fatty acids. Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients. Modulation of postoperative immune and inflammatory response by immune-enhancing enteral diet in gastrointestinal cancer patients. ω-3 Fatty acids have no impact on serum lactate levels after major gastric cancer surgery. EFFECTS OF STANDARD AND/OR GLUTAMINE DIPEPTIDE AND/OR OMEGA-3 FATTY ASCID-SUPPLEMENTED PARENTERAL NUTRITION ON NEUTROPHIL FUNCTIONS, INTERLEUKIN-8 LEVEL AND LENGTH OF STAY--A DOUBLE BLIND,CONTROLLED, RANDOMISED STUDY. Influence of preoperative administration of omega-3 fatty acid-enriched supplement on inflammatory and immune responses in patients undergoing major surgery for cancer. Omega-3 fatty acids improve liver and pancreas function in postoperative cancer patients. Impact of fish oil enriched total parenteral nutrition on elderly patients after colorectal cancer surgery. Short-Time Infusion of Fish Oil-Based Lipid Emulsions, Approved for Parenteral Nutrition, Reduces Monocyte Proinflammatory Cytokine Generation and Adhesive Interaction with Endothelium in Humans 1 Early enteral feeding in postsurgical cancer patients. Fish oil structured lipid-based polymeric formula versus a standard polymeric formula.
OBJECTIVE Nutritive immunomodulation of patients after major surgery . DESIGN Prospect i ve , r and omized controlled double-blind study . PATIENTS Forty patients undergoing major intestinal surgery . Patients were divided into two groups : one received a total parenteral nutrition enriched with omega-3 fatty acids for 5 days postoperatively , the other an isocaloric , control nutrition . MATERIAL S AND METHODS We analyzed the leukocyte ability to release leukotrienes from whole blood leukocytes stimulated with the calcium ionophore A23187 ( 5 micromol/L ) by reverse phase high-performance liquid chromatography and circulating cytokines by enzyme-linked immunosorbent assay . RESULTS Leukocytes from patients of the omega-3 fatty acids group generated significantly higher amounts of less biologically active leukotriene B5 as compared to the control group ( p < or = 0.001 ) . This was accompanied by a significant decrease in the generation of proinflammatory leukotriene B4 ( p < or = 0.006 ) in the study group . In contrast to interleukin-1beta , interleukin-6 , and interleukin-10 systemic levels of tumor necrosis factor-alpha ( p < or = 0.05 ) were postoperatively decreased in the study group . CONCLUSION Our data provide evidence that a total parenteral nutrition enriched with omega-3 fatty acids modulates the lipid mediator pattern and systemic tumor necrosis factor-alpha levels Cancer chemotherapy is associated with neutropenia and impaired neutrophil function . This study aim ed to investigate whether supplementation with low dose fish oil ( FO ) , providing n-3 polyunsaturated fatty acids , in cancer patients receiving chemotherapy after surgical tumor ( mainly gastrointestinal ) removal is able to improve the function of blood neutrophils .  Patients ( n = 38 ) receiving chemotherapy ( 5-fluorouracil and leucovorin )  were r and omized into two groups ; one group ( control ) did not receive a supplement , while the other group ( FO ) received 2 g FO/day for 8 weeks ; the FO provided 0.3 g eicosapentaenoic acid plus 0.4 g docosahexaenoic acid per day . Patients in the control group lost an average of 2.5 kg of weight over the 8 weeks of the study . The number of blood polymorphonuclear cells ( PMNC ) , mainly neutrophils , and their functions ( phagocytosis and hydrogen peroxide production ) decreased in the control group ( average decreases of approximately 30 , 45 and 17 % , respectively ) . FO prevented these decreases and actually increased body weight ( average of 1.7 kg weight gain ; p < 0.002 vs. control group ) , PMNC number ( average 29 % increase ) , phagocytosis ( average 14 % increase ) and superoxide production ( average 28 % increase ) . FO may be useful in preventing chemotherapy-induced decline in neutrophil number and function Abstract Background A lipid emulsion composed of soybean oil ( long-chain triglycerides , LCT ) , medium-chain triglycerides ( MCT ) and n-3 poly-unsaturated fatty acids ( PUFAs ) was evaluated for immune-modulation efficacy , safety , and tolerance in patients undergoing major surgery for gastric and colorectal cancer . Methods In a prospect i ve , r and omized , double-blind study , 99 patients with gastric and colorectal cancer receiving elective surgery were recruited and r and omly assigned to either the study group , receiving the n-3 PUFAs enriched intravenous fat emulsion ( IVFE ) , or the control group , receiving a lipid emulsion comprised of soybean oil and MCTs ( 0.8 – 1.5 g · kg-1 · day-1 ) as part of total parenteral nutrition ( TPN ) regimen from surgery ( day -1 ) up to post-operative day 7 . Safety and efficacy parameters were assessed on day -1 and post-operative visits on day 1 , 3 , and 7 . Adverse events were documented daily and compared between the groups . Results Pro-inflammatory markers , laboratory parameters , and adverse events did not differ prominently between the 2 groups , with the exception of net changes ( day 7 minus day -1 ) of free fatty acids ( FFAs ) , triglyceride , and high-density lipoprotein ( HDL ) . Net decrease of FFAs was remarkably higher in the study group , while the net increase of triglyceride and decrease of HDL was significantly lower . Conclusions The n-3 PUFA-enriched IVFE showed improvements in lipid metabolism . In respect of efficacy , safety and tolerance both IVFE were comparable . In patients with severe stress , there is an inflammation-attenuating effect of n-3 PUFAs . Further , adequately powered clinical trials will be necessary to address this question in postsurgical GI cancer patients .Trial registration US Clinical Trials.gov NCT00798447 Specific immunonutrients may reduce the incidence of postoperative complications and shorten recovery time . This r and omized trial evaluated the clinical efficacy of a fish oil emulsion on outcome and immune function after gastrointestinal cancer surgery Background Nutrients such as ω-3 fatty acids including fish oil components eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) suppress the growth and promote apoptosis of tumor cells , improve immune function and reduce the effects of systemic inflammatory response syndrome . We sought to investigate the effect of ω-3 fish oil fat emulsion-based parenteral nutrition ( PN ) on nutritional state , immune function , inflammatory reaction , expression of tumor factors and complication incidence in patients after surgical resection of gastric cancer . Methods Forty-eight patients after surgical operation of gastric tumor in hospital were r and omly divided into the control group and intervention group . Patients in both groups were treated with iso-nitrogen and iso-caloric parenteral nutrition support . In addition , the intervention group received ω-3 fish oil fat emulsion and the control group received soybean oil . The indicators of nutrition , immune function and inflammation in the two groups were detected on the day before the operation and postoperative day 6 . The rate of complication was compared between the two groups . Results There was no significant difference in nutritional state , liver function and renal function between the two groups ( P > 0.05 ) . However , the levels of inflammatory markers were significantly decreased ( P < 0.01 ) , and the rate of complication was also decreased in the intervention group as compared with the control group . Conclusions ω-3 fish oil fat emulsion-based parenteral nutrition alleviates the inflammatory reaction and reduces the rate of inflammatory complications OBJECTIVES Recent studies in animal models of sepsis-induced acute respiratory distress syndrome ( ARDS ) have shown that a low-carbohydrate , high-fat diet combining the anti-inflammatory and vasodilatory properties of eicosapentaenoic acid ( EPA ; fish oil ) , gamma-linolenic acid ( GLA ; borage oil ) ( EPA+GLA ) , and antioxidants improves lung microvascular permeability , oxygenation , and cardiopulmonary function and reduces proinflammatory eicosanoid synthesis and lung inflammation . These findings suggest that enteral nutrition with EPA+GLA and antioxidants may reduce pulmonary inflammation and may improve oxygenation and clinical outcomes in patients with ARDS . DESIGN Prospect i ve , multicentered , double-blind , r and omized controlled trial . SETTING Intensive care units of five academic and teaching hospitals in the United States . PATIENTS We enrolled 146 patients with ARDS ( as defined by the American-European Consensus Conference ) caused by sepsis/pneumonia , trauma , or aspiration injury in the study . INTERVENTIONS Patients meeting entry criteria were r and omized and continuously tube-fed either EPA+GLA or an isonitrogenous , isocaloric st and ard diet at a minimum caloric delivery of 75 % of basal energy expenditure x 1.3 for at least 4 - 7 days . MEASUREMENTS AND MAIN RESULTS Arterial blood gases were measured , and ventilator setting s were recorded at baseline and study days 4 and 7 to enable calculation of PaO2/FIO2 , a measure of gas exchange . Pulmonary neutrophil recruitment was assessed by measuring the number of neutrophils and the total cell count in bronchoalveolar lavage fluid at the same time points . Clinical outcomes were recorded . Baseline characteristics of 98 evaluable patients revealed that key demographic , physiologic , and ventilatory variables were similar at entry between both groups . Multiple bronchoalveolar lavages revealed significant decreases ( approximately 2.5-fold ) in the number of total cells and neutrophils per mL of recovered lavage fluid during the study with EPA+GLA compared with patients fed the control diet . Significant improvements in oxygenation ( PaO2/FIO2 ) from baseline to study days 4 and 7 with lower ventilation variables ( FIO2 , positive end-expiratory pressure , and minute ventilation ) occurred in patients fed EPA+GLA compared with controls . Patients fed EPA+GLA required significantly fewer days of ventilatory support ( 11 vs. 16.3 days ; p = .011 ) , and had a decreased length of stay in the intensive care unit ( 12.8 vs. 17.5 days ; p = .016 ) compared with controls . Only four of 51 ( 8 % ) patients fed EPA+GLA vs. 13 of 47 ( 28 % ) control patients developed a new organ failure during the study ( p = .015 ) . CONCLUSIONS The beneficial effects of the EPA+GLA diet on pulmonary neutrophil recruitment , gas exchange , requirement for mechanical ventilation , length of intensive care unit stay , and the reduction of new organ failures suggest that this enteral nutrition formula would be a useful adjuvant therapy in the clinical management of patients with or at risk of developing ARDS Summary Previous studies have suggested that administration of oral eicosapentaenoic acid ( EPA ) will stabilize weight in patients with advanced pancreatic cancer . The aim of the present study was to determine if a combination of EPA with a conventional oral nutritional supplement could produce weight gain in these patients . Twenty patients with unresectable pancreatic adenocarcinoma were asked to consume two cans of a fish oil-enriched nutritional supplement per day in addition to their normal food intake . Each can contained 310 kcal , 16.1 g protein and 1.09 g EPA . Patients were assessed for weight , body composition , dietary intake , resting energy expenditure ( REE ) and performance status . Patients consumed a median of 1.9 cans day–1 . All patients were losing weight at baseline at a median rate of 2.9 kg month–1 . After administration of the fish oil-enriched supplement , patients had significant weight-gain at both 3 ( median 1 kg , P = 0.024 ) and 7 weeks ( median 2 kg , P = 0.033 ) . Dietary intake increased significantly by almost 400 kcal day–1 ( P = 0.002 ) . REE per kg body weight and per kg lean body mass fell significantly . Performance status and appetite were significantly improved at 3 weeks . In contrast to previous studies of oral conventional nutritional supplements in weight-losing cancer patients , this study suggests that an EPA-enriched supplement may reverse cachexia in advanced pancreatic cancer It has been increasingly reported that administration of n-3 fatty acids is beneficial in patients with inflammatory processes . This effect is most likely caused by different biological characteristics , including an immunomodulating effect of the products derived from n-3 fatty acids through eicosanoid metabolism . The aim of this study was to investigate the effect of perioperative administration of n-3 fatty acids on inflammatory and immune responses as well as on the postoperative course of patients with extended surgical interventions of the abdomen . In particular , the effect of n-3 fatty acids on interleukin-6 release and on granulocyte/monocyte function ( HLA-DR expression ) was studied . There was a downregulation of the inflammatory response , and , simultaneously , a smaller postoperative immune suppression in the n-3  fatty acid group . In addition , we observed shorter postoperative periods in the intensive care unit and on the regular medical wards as well as lower rates of severe infections . The results suggest that perioperative administration of n-3 fatty acids may have a favourable effect on outcome in patients with severe surgical interventions by lowering the magnitude of inflammatory response and by modulating the immune response AIM To investigate the effect of omega-3 fatty acid parenteral supplementation postoperatively on clinical outcomes and immunomodulation in colorectal cancer patients . METHODS Forty-two patients undergoing radical colorectal cancer resection with an indication for total parenteral nutrition postoperatively were enrolled in this prospect i ve , double-blind , r and omized , controlled study . Patients received total parenteral nutrition supplemented with either soybean oil ( LCT ; Intralipid , Fresenius-Kabi , SO group , n = 21 ) or a combination of omega-3 fish oil and soybean oil ( LCT : fish oil = 5:1 , fish oil ; Omegaven , Fresenius-Kabi , FO group , n = 21 ) , up to a total of 1.2 g lipid/kg per day for 7 d postoperatively . A same volume calorie and nitrogen was administrated . Routine blood test , biochemistry , systemic levels of IL-6 and TNF-alpha , percentage of CD3 + , CD4 + , and CD8 + lymphocytes were evaluated preoperatively and on postoperative d 1 and 8 . Patient outcome was evaluated considering mortality during the hospital stay , length of postoperative hospital stay , and occurrence of infectious complications . RESULTS Both lipid regimens were well tolerated . No differences between the two groups were noticed in demographics , baseline blood test , biochemistry , serum levels of IL-6 and TNF-alpha , percentage of CD4 + , CD8 + lymphocytes , and ratios of CD4+/CD8 + . Compared with those on postoperative d 1 , serum IL-6 levels on postoperative d 8 were significantly depressed in the FO group than in the reference group ( -44.43 + /- 30.53 vs -8.39 + /- 69.08 , P = 0.039 ) . Simultaneously , the ratios of CD4+/CD8 + were significantly increased in the FO group ( 0.92 + /- 0.62 vs 0.25 + /- 1.22 , P = 0.035 ) . In addition , depression of serum TNF-alpha levels ( -0.82 + /- 2.71 vs 0.27 + /- 1.67 , P = 0.125 ) and elevation of CD3 + and CD4 + lymphocyte percentage ( 12.85 + /- 11.61 vs 3.84 + /- 19.62 , P = 0.081 , 17.80 + /- 10.86 vs 9.66 + /- 17.55 , P = 0.084 , respectively ) were higher in the FO group than in the reference group . Patients in the FO group tended to need a shorter postoperative hospital stay ( 17.45 + /- 4.80 d vs 19.62 + /- 5.59 d , P = 0.19 ) . No statistically significant difference was found when stratified to mortality and occurrence of infectious complications . CONCLUSION Postoperative supplementation of omega-3 fatty acids may have a favorable effect on the outcomes in colorectal cancer patients undergoing radical resection by lowering the magnitude of inflammatory responses and modulating the immune response AIM To evaluate if the administration of an enteral diet supplemented with glutamine , arginine and omega-3-fatty acids modulates inflammatory and immune responses after surgery . METHODS A prospect i ve r and omized double-blind , clinical trial was performed . Forty-eight patients with gastrointestinal cancer were r and omized into two groups , one group was given an isocaloric and isonitrogenous st and ard diet and the other was fed with the supplemented diet with glutamine , arginine and omega-3-fatty acids . Feedings were started within 48 hours after operation , and continued until day 8 . All variables were measured before operation and on postoperative day 1 and 8 . Immune responses were determined by phagocytosis ability , respiratory burst of polymorphonuclear cells , total lymphocytes lymphocyte subsets , nitric oxide , cytokines concentration , and inflammatory responses by plasma levels of C-reactive protein , prostagl and in E2 level . RESULTS Tolerance of both formula diets was excellent . There were significant differences in the immunological and inflammatory responses between the two groups . In supplemented group , phagocytosis and respiratory burst after surgery was higher and C-reactive protein level was lower ( P<0.01 ) than in the st and ard group . The supplemented group had higher levels of nitric oxide , total lymphocytes , T lymphocytes , T-helper cells , and NK cells . Postoperative levels of IL-6 and TNF-alpha were lower in the supplemented group ( P < 0.05 ) . CONCLUSION It was clearly established in this trial that early postoperative enteral feeding is safe in patients who have undergone major operations for gastrointestinal cancer . Supplementation of enteral nutrition with glutamine , arginine , and omega-3-fatty acids positively modulated postsurgical immunosuppressive and inflammatory responses BACKGROUND Preoperative and intraoperative nutrition support in patients undergoing major surgery results in decreased incidence of morbidity and mortality . Studies investigating the role of ω-3 fatty acids in these patients are increasing . Some are focused on perfusion at the cellular level . This study was undertaken to address the effect of postoperative administration of ω-3 fatty acids on cellular hypoperfusion associated with major gastric surgery . METHODS Twenty-six patients undergoing gastric cancer surgery were r and omly assigned to receive parenteral nutrition ( PN ) supplemented with a combination of ω-6 and ω-3 fatty acids ( Omegaven , 0.2 g/kg/d ; Lipovenoes 10 % , 0.6 g/kg/d ) or with ω-6 fatty acid ( Lipovenoes 10 % , 0.8 g/kg/d ) for 5 days . Blood sample s were taken preoperatively , postoperative day 1 , and on the last day of PN therapy ( day 5 ) . RESULTS Patients receiving ω-3 and ω-6 fatty acids showed neither lower serum lactate levels nor lower rates of complications compared with patients receiving ω-6 only . There were no statistically significant differences between the groups in other biochemical parameters , complications , or length of hospital stay or mortality . CONCLUSION PN with ω-3 fatty acid supplementation does not have a significant impact on cellular hypoperfusion and lactate clearance after major gastric surgery BACKGROUND AND AIMS Protein calorie malnutrition for cancer patients is related with altered cellular and humoral immunity . St and ard TPN and glutamine and lipid emulsion with omega 3 fatty acids were given to colorectal cancer patients and the effects of these to neutrophil functions and IL-8 levels are compared . METHODS Consecutive 36 patients with colorectal cancer diagnosed with endoscopic biopsy and with malnutrition determined by subjective global assessment were enrolled to study . The patients are r and omly divided into four groups . St and ard TPN to control group , TPN with glutamine solution to S-D group , TPN with omega 3 fatty acid solution to S-O group and TPN with omega 3 fatty acids solution and glutamine to S-D-O group were given for seven days after the operation . At the preoperative , postoperative first day and 7th day , neutrophil phagocytosis index , neutrophil adhesivity index and IL-8 levels were determined . RESULTS In all groups compared to control group neutrophil phagocytosis index were increased significantly ( p<0.05 ) . The most increasing was in group 3 . There was n't significant difference between groups about postoperative first day neutrophil adhesiveness index ( p>0.05 ) . At the 7th day the neutrophil adhesivity index for study groups were increased compared with control group , but there was no significant differences between groups . There was no significant difference between groups for IL-8 levels . CONCLUSIONS As a result of the study , altered cellular immunity in colorectal cancer patients with malnutrition can be corrected with omega 3 fatty acid emulsions and glutamine added to TPN so the ratio of morbidity and mortality can be decreased OBJECTIVE Polyunsaturated fatty acid supplementation may produce beneficial effects after surgery . We investigated the influence of preoperative administration of a supplement rich in arginine , omega-3 fatty acids , and RNA , Impact ( Japan ) , on inflammatory and immune responses in patients undergoing major surgery for cancer . METHODS Patients in the supplement group ( n = 12 ) received 1 L/d of Impact ( Japan ) for 5 d before surgery , and those in the control group ( n = 14 ) received an ordinary diet without Impact ( Japan ) before surgery . Plasma levels of omega-3 and omega-6 fatty acids , thromboxane B(2 ) , prostagl and in E(2 ) , inflammatory markers , nutritional markers , cytokines , and cytokine receptors were obtained 5 d before the operation at the starting point of supplementation in the supplement group . Sample s were collected on postoperative days ( PODs ) 0 , 1 , 3 , and 7 . RESULTS After taking the supplement , significant increases in omega-3 fatty acids and rapid turnover proteins were found the day after ending supplementation ( POD-0 ) , whereas thromboxane B(2 ) levels and the ratio of omega-6 fatty acids to omega-3 fatty acids were significantly lower than before supplementation ( P < 0.001 ) . On POD-0 only , inflammatory markers and cytokine receptors in the supplement group showed low levels in comparison with the control group ( P < 0.05 ) . On POD-1 and POD-3 , remarkable decreases in polymorphonuclear leukocyte-elastase and interleukin-8 in the supplement group were observed . CONCLUSION Our findings suggest that oral administration of a supplement rich in omega-3 fatty acids for 5 d before surgery may improve not only preoperative nutritional status but also preoperative and postoperative inflammatory and immune responses in patients who have cancer Epidemiologic studies have indicated that high intake of saturated fat and /or animal fat increases the risk of colon and breast cancer . Omega-3 PUFAs in fish oil ( FO ) can inhibit the growth of human cancer cells in vitro and in vivo . These effects are related to the uptake of eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) into the cellular substrate pool and their competitive metabolism with arachidonic acid ( AA ) at the cyclooxygenase and 5-lipoxygenase levels . The metabolites of EPA and DHA have less inflammatory and immunosuppressant potency than the substances derived from AA . Based on previous experimental data , we hypothesized that FO supplementation after major abdominal cancer surgery would improve hepatic and pancreatic function . Ours was a prospect i ve , r and omized , double-blinded clinical trial on 44 patients undergoing elective major abdominal surgery , r and omly assigned to receive total parenteral nutrition ( TPN ) supplemented with either soybean oil ( SO 1.0 g/kg body weight daily , n = 20 ) for 5 days or a combination of FO and SO ( FO 0.2 + SO 0.8 g/kg body weight daily , n = 24 ) . Compared to pure SO supplementation in the postoperative period , FO significantly reduced ASAT [ 0.8 + /- 0.1 vs. 0.5 + /- 0.1 mmol/(l . sec ) ] , ALAT [ 0.9 + /- 0.1 vs. 0.6 + /- 0.1 mmol/(l . sec ) ] , bilirubin ( 16.1 + /- 5.3 vs. 6.9 + /- 0.6 mmol/l ) , LDH ( 7.7 + /- 0.4 vs. 6.7 + /- 0.4 mmol/(l . sec ) and lipase ( 0.6 + /- 0.1 vs. 0.4 + /- 0.1 micromol/(l . sec ) in the postoperative course . Moreover , patients with increased risk of sepsis ( IL-6/IL-10 ratio > 8) showed a tendency to shorter ICU stay ( 18 hr ) under omega-3 PUFA treatment . Weight loss as encountered after the SO emulsion of 1.1 + /- 2.2 kg was absent in the FO group . After major abdominal tumor surgery , FO supplementation improved liver and pancreas function , which might have contributed to the faster recovery of patients BACKGROUND Polyunsaturated omega-3 fatty acids may beneficially influence healing processes and patient outcomes . The aim of this research was to study the clinical efficacy of fish oil enriched total parenteral nutrition in elderly patients after colorectal cancer surgery . METHODS Fifty-seven elderly patients with colorectal cancer were enrolled in this prospect i ve , r and omized , double-blind , controlled clinical trial . All patients received isocaloric and isonitrogenous total parenteral nutrition by continuous infusion ( 20 - 24 hours per day ) for seven days after surgery . The control group ( n = 28 ) received 1.2 g/kg soybean oil per day , whereas the treatment group ( n = 29 ) received 0.2 g/kg fish oil and 1.0 g/kg soybean oil per day . Blood sample s were taken pre-operatively , and at days one and eight after the operation . The plasma levels of CD4 , CD8 , CD4/CD8 , interleukin 6 ( IL-6 ) and tumor necrosis factor α ( TNF-α ) were measured . Clinical outcomes were then analysed . RESULTS Patient characteristics were comparable between the two groups . At day eight post-surgery , IL-6 , TNF-α and CD8 titres were lower in the treatment group when compared to the control group ; these results reached statistical significance . In the treatment group , there were fewer infectious complications and incidences of systemic inflammatory response syndrome ( SIRS ) , and shorter lengths of hospital stay were observed . The total cost of medical care was comparable for the two groups . No serious adverse events occurred in either group . CONCLUSIONS Fish oil 0.2 g/kg per day administrated to elderly patients after colorectal surgery was safe and may shorten the length of hospital stay and improve clinical outcomes Potential impact of ω-3 fatty acids , as contained in fish oil , on immunological function has been suggested because observations of reduced inflammatory diseases in Greenl and Inuit were published . A fish oil-based lipid emulsion has recently been approved for parenteral nutrition in many countries . We investigated the influence of a short infusion course of fish oil-based ( ω-3 ) vs conventional ( ω-6 ) lipid emulsion on monocyte function . In a r and omized design , twelve healthy volunteers received ω-3 or ω-6 lipid infusion for 48 h , with cross-over repetition of the infusion course after 3 mo . Fatty acid profiles , monocyte cytokine release and adhesive monocyte-endothelium interaction were investigated . Result ant ω-6 lipid emulsion increased plasma-free fatty acids including arachidonic acid , whereas the ω-3/ω-6 fatty acid ratio in monocyte membranes remained largely unchanged . It also caused a tendency toward enhanced monocyte proinflammatory cytokine release and adhesive monocyte-endothelium interaction . In contrast , ω-3 lipid emulsion significantly increased the ω-3/ω-6 fatty acid ratio in the plasma-free fatty acid fraction and in monocyte membrane lipid pool , markedly suppressing monocyte generation of TNF-α , IL-1 , IL-6 , and IL-8 in response to endotoxin . In addition , it also significantly inhibited both monocyte-endothelium adhesion and transendothelial monocyte migration , although monocyte surface expression of relevant adhesive molecules ( CD11b , CD18 , CD49 days , CCR2 ) was unchanged . Although isocaloric , ω-3 and ω-6 lipid emulsions exert differential impact on immunological processes in humans . In addition to its nutritional value , fish oil-based ω-3 lipid emulsion significantly suppresses monocyte proinflammatory cytokine generation and features of monocyte recruitment OBJECTIVES The authors compared the safety , gastrointestinal tolerance , and clinical efficacy of feeding an enteral diet containing a fish oil/medium-chain triglyceride structured lipid ( FOSL-HN ) versus an isonitrogenous , isocaloric formula ( O-HN ) in patients undergoing major abdominal surgery for upper gastrointestinal malignancies . SUMMARY BACKGROUND DATA Previous studies suggest that feeding with n-3 fatty acids from fish oil can alter eicosanoid and cytokine production , yielding an improved immunocompetence and a reduced inflammatory response to injury . The use of n-3 fatty acids as a structured lipid can improve long-chain fatty acid absorption . METHODS This prospect i ve , blinded , r and omized trial was conducted in 50 adult patients who were jejunally fed either FOSL-HN or O-HN for 7 days .  Serum chemistries , hematology , urinalysis , gastrointestinal complications , liver and renal function , plasma and erythrocyte fatty acid analysis , urinary prostagl and ins , and outcome parameters were measured at baseline and on day 7 . Comparisons were made in 18 and 17 evaluable patients based a priori on the ability to reach a tube feeding rate of 40 mL/hour . RESULTS Patients receiving FOSL-HN experienced no untoward side effects , significant incorporation of eicosapentaenoic acid into plasma and erythrocyte phospholipids , and a 50 % decline in the total number of gastrointestinal complications and infections compared with patients given O-HN . The data strongly suggest improved liver and renal function during the postoperative period in the FOSL-HN group . CONCLUSION Early enteral feeding with FOSL-HN was safe and well tolerated . Results suggest that the use of such a formula during the postoperative period may reduce the number of infections and gastrointestinal complications per patient , as well as improve renal and liver function through modulation of urinary prostagl and in levels . Additional clinical trials to fully quantify clinical benefits and optimize nutritional support with FOSL-HN should be undertaken
BACKGROUND AND OBJECTIVES Omega-3 fatty acids are widely used in nutritional support .
However , whether parenteral supplementation with ω-3 fatty acids is effective for gastrointestinal cancer patients remains uncertain .
This study assessed the effects of this form of parenteral nutrition on immune function and clinical outcomes in postoperative gastrointestinal cancer patients .