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Akut Solunum Sıkıntısı Sendromu Olan Hastalarda Omega-3 Kullanımının Hemodinamik ve Biyokimyasal Parametrelere Etkisinin Retrospektif Analizi

Year 2021, , 816 - 822, 27.12.2021
https://doi.org/10.31832/smj.927439

Abstract

Amaç: Bu çalışmanın amacı; ARDS gelişen hastalarda kullanılan omega-3’ün hemodinamik ve biyokimyasal parametrelere etkisini incelemektir.
Gereç ve Yöntem: Çalışmada, bir eğitim ve araştırma hastanesinin anesteziyoloji ve reanimasyon yoğun bakım ile cerrahi yoğun yakım ünitelerinde Ocak 2017-Ocak 2020 tarihleri arasında takip edilen 18 yaşından büyük, omega-3 desteği alan ARDS hastalarının kayıtları retrospektif olarak incelendi.
Bulgular: Hastaların medyan GKS skoru 9,61±4,36 ve medyan APACHE II skoru 20,86±9,22 olarak bulundu. Hastaların omega-3 aldıktan sonraki lökosit değeri (9,69±4,84), almadan önceki lökosit değerine (12,62±7,01) göre istatistiksel olarak anlamlı düşüktü (p=0,000). Benzer şekilde hastaların omega-3 aldıktan sonraki CRP düzeyi (33,10±48,15), almadan önceki CRP düzeyine (63,08±89,29) göre istatistiksel olarak anlamlı düşüktü (p=0,001). Omega-3 aldıktan sonra hastaların prealbumin değeri (26,83±5,04), almadan önceki değere (25,40±4,12) göre istatistiksel olarak anlamlı yüksekti (p=0,014). Ancak omega-3 kullanımının hastaların hemoglobin değerinde istatistiksel olarak anlamlı bir farklılık oluşturmadığı belirlendi (p=0,542).
Sonuç: ARDS gelişen hastalarda omega-3 kullanımı bazı hemodinamik ve biyokimyasal parametrelerde iyileşme ile ilişkilendirilebilir. Çalışma bulgularını desteklemek adına daha fazla araştırmaya ihtiyaç vardır.

Supporting Institution

çalışmayı destekleyen kişi ya da kuruluşlar bulunmamaktadır.

References

  • 1. Fan E, Brodie D, Slutsky AS. Acute respiratory distress syndrome: advances in diagnosis and treatment. Jama 2018;319(7):698-710.
  • 2. Papazian L, Aubron C, Brochard L, Chiche J-D, Combes A, Dreyfuss D, et al. Formal guidelines: management of acute respiratory distress syndrome. Ann Intensive Care 2019;9(1):69.
  • 3. Confalonieri M, Salton F, Fabiano F. Acute respiratory distress syndrome. European Respiratory Review 2017;26(144):1-7.
  • 4. Artigas A, Carlet J, Le Gall J, Chastang C, Blanch L. Clinical presentation, prognostic factors, and outcome of ARDS in the European Collaborative Study (1985-1987). Lung biology in health and disease 1991;50:37-63.
  • 5. Koçan S, Aktuğ C. Nefes alamıyorum: COVID-19 ve akut respiratuvar distress sendromu. İçinde: Gürsoy A (eds.), Cerrahi Hastalıkları Hemşireliği ve COVID-19. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. s: 15-18.
  • 6. Parish M, Valiyi F, Hamishehkar H, Sanaie S, Asghari Jafarabadi M, Golzari SE, et al. The Effect of Omega-3 Fatty Acids on ARDS: A Randomized Double-Blind Study. Adv Pharm Bull 2014;4(Suppl 2):555-561.
  • 7. Gadek JE, DeMichele SJ, Karlstad MD, Pacht ER, Donahoe M, Albertson TE, et al. 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. Crit Care Med 1999;27(8):1409-1420.
  • 8. Calder P, Grimble R. Polyunsaturated fatty acids, inflammation and immunity. European journal of clinical nutrition 2002;56(3):14-19.
  • 9. Calder PC. Polyunsaturated fatty acids, inflammation, and immunity. Lipids 2001;36(9):1007-1024.
  • 10. Stapleton RD, Martin TR, Weiss NS, Crowley JJ, Gundel SJ, Nathens AB, et al. A phase II randomized placebo-controlled trial of omega-3 fatty acids for the treatment of acute lung injury. Critical care medicine 2011;39(7):1655.
  • 11. Rice TW, Wheeler AP, Thompson BT, DeBoisblanc BP, Steingrub J, Rock P. Enteral omega-3 fatty acid, γ-linolenic acid, and antioxidant supplementation in acute lung injury. Jama 2011;306(14):1574-1581.
  • 12. Çelik F, Edipoğlu İS. Yoğun Bakım Hastalarında Erken Enteral İmmünonütrisyon Uygulamasının Enflamatuvar Yanıta Etkisi. Turkish Journal of Intensive Care 2019;17(2): 88-95.
  • 13. Turner KL, Moore FA, Martindale R. Nutrition support for the acute lung injury/adult respiratory distress syndrome patient: a review. Nutrition in Clinical Practice 2011;26(1):14-25.
  • 14. Xu J, Pan T, Qi X, Tan R, Wang X, Liu Z, et al. Increased mortality of acute respiratory distress syndrome was associated with high levels of plasma phenylalanine. Respir Res 2020;21:99.
  • 15. Guervilly C, Lacroix R, Forel JM, Roch A, Camoin-Jau L, Papazian L, et al. High levels of circulating leukocyte microparticles are associated with better outcome in acute respiratory distress syndrome. Critical Care 2011;15(1): 1-10.
  • 16. Dilektaşlı AS, Bostan PP, Salepçi B, Çetinkaya PD, Dülger S, Arpaz S, et al. Türkiye ve Ulusal Tütün Kontrolü. Sürekli Tıp Eğitimi Dergisi 2020;29: 34-42.
  • 17. Kim WY, Hong SB. Sepsis and acute respiratory distress syndrome: recent update. Tuberculosis and respiratory diseases 2016;79(2):53.
  • 18. Koekkoek WK, Panteleon V, Van Zanten AR. Current evidence on ω-3 fatty acids in enteral nutrition in the critically ill: A systematic review and meta-analysis. Nutrition 2019;59: 56-68.
  • 19. Santacruz CA, Orbegozo D, Vincent JL, Preiser JC. Modulation of dietary lipid composition during acute respiratory distress syndrome: systematic review and meta‐analysis. Journal of Parenteral and Enteral Nutrition 2015; 39(7), 837-846.
  • 20. Langlois PL, D'Aragon F, Hardy G, Manzanares W. Omega-3 polyunsaturated fatty acids in critically ill patients with acute respiratory distress syndrome: A systematic review and meta-analysis. Nutrition 2019; 61:84-92.
  • 21. Pradelli L, Mayer K, Muscaritoli M, Heller AR. n-3 fatty acid-enriched parenteral nutrition regimens in elective surgical and ICU patients: a meta-analysis. Critical Care 2012;16(5):1-10.
  • 22. Rosenthal MD, Moore FA. Persistent inflammatory, immunosuppressed, catabolic syndrome (PICS): A new phenotype of multiple organ failure. Journal of advanced nutritional and human metabolism 2015:1;1.
  • 23. Mizock BA, DeMichele SJ. The acute respiratory distress syndrome: role of nutritional modulation of inflammation through dietary lipids. Nutrition in clinical practice 2004; 19(6):563-574.
  • 24. Grimminger F, Wahn H, Mayer K, Kiss L, Walmrath D, Seeger W. Impact of arachidonic versus eicosapentaenoic acid on exotonin-induced lung vascular leakage: relation to 4-series versus 5-series leukotriene generation. American journal of respiratory and critical care medicine 1997;155(2):513-519.
  • 25. Yeh KY, Wang HM, Chang JWC, Huang JS, Lai CH, Lan YJ, et al. Omega-3 fatty acid-, micronutrient-, and probiotic-enriched nutrition helps body weight stabilization in head and neck cancer cachexia. Oral surgery, oral medicine, oral pathology and oral radiology 2013;116(1): 41-48.
  • 26. Krzak A, Pleva M, Napolitano LM. Nutrition therapy for ALI and ARDS. Critical care clinics 2011;27(3): 647-659.
  • 27. Pontes‐Arruda A, DeMichele S, Seth A, Singer P. The use of an inflammation‐modulating diet in patients with acute lung injury or acute respiratory distress syndrome: a meta‐analysis of outcome data. Journal of Parenteral and Enteral Nutrition 2008;32(6): 596-605.
  • 28. García de Acilu M, Leal S, Caralt B, Roca O, Sabater J, Masclans JR. The Role of Omega-3 Polyunsaturated Fatty Acids in the Treatment of Patients with Acute Respiratory Distress Syndrome: A Clinical Review. Biomed Res Int 2015;653-750.
  • 29. Sabater J, Masclans JR, Sacanell J, Chacon P, Sabin P, Planas M. Effects on hemodynamics and gas exchange of omega-3 fatty acid-enriched lipid emulsion in acute respiratory distress syndrome (ARDS): a prospective, randomized, double-blind, parallel group study. Lipids in health and disease 2008;7(1):1-9.
  • 30. Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clinical nutrition 2019;38(1): 48-79.
  • 31. McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). Journal of parenteral and enteral nutrition 2009;33(3):277-316.

Retrospective Analysis of The Effect of Omega-3 Use on Hemodynamic and Biochemical Parameters in Patients with Acute Respiratory Distress Syndrome

Year 2021, , 816 - 822, 27.12.2021
https://doi.org/10.31832/smj.927439

Abstract

Objective: The aim of this study is; To examine the effect of omega-3 used in patients with ARDS on hemodynamic and biochemical parameters.
Materials and Methods: In the study, the records of ARDS patients over the age of 18 who received omega-3 support between January 2017 and January 2020 in the anesthesiology and reanimation intensive care unit of a training and research hospital were analyzed retrospectively.
Results: The median GCS score of the patients was 9.61 ± 4.36 and the median APACHE II score was 20.86 ± 9.22. The leukocyte value of the patients after taking omega-3 (9.69 ± 4.84) was statistically significantly lower than the leukocyte value (12.62 ± 7.01) before taking omega-3 (p = 0.000). Similarly, the CRP level (33.10 ± 48.15) of the patients after taking omega-3 was statistically significantly lower than the CRP level before taking omega-3 (63.08 ± 89.29) (p = 0.001). The prealbumin value (26.83 ± 5.04) of the patients after taking omega-3 was statistically significantly higher than the value before taking (25.40 ± 4.12) (p = 0.014).
However, it was determined that the use of omega-3 did not create a statistically significant difference in hemoglobin values of the patients (p = 0.542).
Conclusion: The use of omega-3 in patients with ARDS may be associated with improvement in some hemodynamic and biochemical parameters. More research is needed to support the study findings.

References

  • 1. Fan E, Brodie D, Slutsky AS. Acute respiratory distress syndrome: advances in diagnosis and treatment. Jama 2018;319(7):698-710.
  • 2. Papazian L, Aubron C, Brochard L, Chiche J-D, Combes A, Dreyfuss D, et al. Formal guidelines: management of acute respiratory distress syndrome. Ann Intensive Care 2019;9(1):69.
  • 3. Confalonieri M, Salton F, Fabiano F. Acute respiratory distress syndrome. European Respiratory Review 2017;26(144):1-7.
  • 4. Artigas A, Carlet J, Le Gall J, Chastang C, Blanch L. Clinical presentation, prognostic factors, and outcome of ARDS in the European Collaborative Study (1985-1987). Lung biology in health and disease 1991;50:37-63.
  • 5. Koçan S, Aktuğ C. Nefes alamıyorum: COVID-19 ve akut respiratuvar distress sendromu. İçinde: Gürsoy A (eds.), Cerrahi Hastalıkları Hemşireliği ve COVID-19. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. s: 15-18.
  • 6. Parish M, Valiyi F, Hamishehkar H, Sanaie S, Asghari Jafarabadi M, Golzari SE, et al. The Effect of Omega-3 Fatty Acids on ARDS: A Randomized Double-Blind Study. Adv Pharm Bull 2014;4(Suppl 2):555-561.
  • 7. Gadek JE, DeMichele SJ, Karlstad MD, Pacht ER, Donahoe M, Albertson TE, et al. 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. Crit Care Med 1999;27(8):1409-1420.
  • 8. Calder P, Grimble R. Polyunsaturated fatty acids, inflammation and immunity. European journal of clinical nutrition 2002;56(3):14-19.
  • 9. Calder PC. Polyunsaturated fatty acids, inflammation, and immunity. Lipids 2001;36(9):1007-1024.
  • 10. Stapleton RD, Martin TR, Weiss NS, Crowley JJ, Gundel SJ, Nathens AB, et al. A phase II randomized placebo-controlled trial of omega-3 fatty acids for the treatment of acute lung injury. Critical care medicine 2011;39(7):1655.
  • 11. Rice TW, Wheeler AP, Thompson BT, DeBoisblanc BP, Steingrub J, Rock P. Enteral omega-3 fatty acid, γ-linolenic acid, and antioxidant supplementation in acute lung injury. Jama 2011;306(14):1574-1581.
  • 12. Çelik F, Edipoğlu İS. Yoğun Bakım Hastalarında Erken Enteral İmmünonütrisyon Uygulamasının Enflamatuvar Yanıta Etkisi. Turkish Journal of Intensive Care 2019;17(2): 88-95.
  • 13. Turner KL, Moore FA, Martindale R. Nutrition support for the acute lung injury/adult respiratory distress syndrome patient: a review. Nutrition in Clinical Practice 2011;26(1):14-25.
  • 14. Xu J, Pan T, Qi X, Tan R, Wang X, Liu Z, et al. Increased mortality of acute respiratory distress syndrome was associated with high levels of plasma phenylalanine. Respir Res 2020;21:99.
  • 15. Guervilly C, Lacroix R, Forel JM, Roch A, Camoin-Jau L, Papazian L, et al. High levels of circulating leukocyte microparticles are associated with better outcome in acute respiratory distress syndrome. Critical Care 2011;15(1): 1-10.
  • 16. Dilektaşlı AS, Bostan PP, Salepçi B, Çetinkaya PD, Dülger S, Arpaz S, et al. Türkiye ve Ulusal Tütün Kontrolü. Sürekli Tıp Eğitimi Dergisi 2020;29: 34-42.
  • 17. Kim WY, Hong SB. Sepsis and acute respiratory distress syndrome: recent update. Tuberculosis and respiratory diseases 2016;79(2):53.
  • 18. Koekkoek WK, Panteleon V, Van Zanten AR. Current evidence on ω-3 fatty acids in enteral nutrition in the critically ill: A systematic review and meta-analysis. Nutrition 2019;59: 56-68.
  • 19. Santacruz CA, Orbegozo D, Vincent JL, Preiser JC. Modulation of dietary lipid composition during acute respiratory distress syndrome: systematic review and meta‐analysis. Journal of Parenteral and Enteral Nutrition 2015; 39(7), 837-846.
  • 20. Langlois PL, D'Aragon F, Hardy G, Manzanares W. Omega-3 polyunsaturated fatty acids in critically ill patients with acute respiratory distress syndrome: A systematic review and meta-analysis. Nutrition 2019; 61:84-92.
  • 21. Pradelli L, Mayer K, Muscaritoli M, Heller AR. n-3 fatty acid-enriched parenteral nutrition regimens in elective surgical and ICU patients: a meta-analysis. Critical Care 2012;16(5):1-10.
  • 22. Rosenthal MD, Moore FA. Persistent inflammatory, immunosuppressed, catabolic syndrome (PICS): A new phenotype of multiple organ failure. Journal of advanced nutritional and human metabolism 2015:1;1.
  • 23. Mizock BA, DeMichele SJ. The acute respiratory distress syndrome: role of nutritional modulation of inflammation through dietary lipids. Nutrition in clinical practice 2004; 19(6):563-574.
  • 24. Grimminger F, Wahn H, Mayer K, Kiss L, Walmrath D, Seeger W. Impact of arachidonic versus eicosapentaenoic acid on exotonin-induced lung vascular leakage: relation to 4-series versus 5-series leukotriene generation. American journal of respiratory and critical care medicine 1997;155(2):513-519.
  • 25. Yeh KY, Wang HM, Chang JWC, Huang JS, Lai CH, Lan YJ, et al. Omega-3 fatty acid-, micronutrient-, and probiotic-enriched nutrition helps body weight stabilization in head and neck cancer cachexia. Oral surgery, oral medicine, oral pathology and oral radiology 2013;116(1): 41-48.
  • 26. Krzak A, Pleva M, Napolitano LM. Nutrition therapy for ALI and ARDS. Critical care clinics 2011;27(3): 647-659.
  • 27. Pontes‐Arruda A, DeMichele S, Seth A, Singer P. The use of an inflammation‐modulating diet in patients with acute lung injury or acute respiratory distress syndrome: a meta‐analysis of outcome data. Journal of Parenteral and Enteral Nutrition 2008;32(6): 596-605.
  • 28. García de Acilu M, Leal S, Caralt B, Roca O, Sabater J, Masclans JR. The Role of Omega-3 Polyunsaturated Fatty Acids in the Treatment of Patients with Acute Respiratory Distress Syndrome: A Clinical Review. Biomed Res Int 2015;653-750.
  • 29. Sabater J, Masclans JR, Sacanell J, Chacon P, Sabin P, Planas M. Effects on hemodynamics and gas exchange of omega-3 fatty acid-enriched lipid emulsion in acute respiratory distress syndrome (ARDS): a prospective, randomized, double-blind, parallel group study. Lipids in health and disease 2008;7(1):1-9.
  • 30. Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clinical nutrition 2019;38(1): 48-79.
  • 31. McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). Journal of parenteral and enteral nutrition 2009;33(3):277-316.
There are 31 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Sema Koçan 0000-0002-9049-3798

Leyla Kazancıoğlu 0000-0002-3833-0692

Yağmur Demirel 0000-0003-3877-3183

Canan Altınsoy 0000-0002-1188-0475

Publication Date December 27, 2021
Submission Date April 25, 2021
Published in Issue Year 2021

Cite

AMA Koçan S, Kazancıoğlu L, Demirel Y, Altınsoy C. Akut Solunum Sıkıntısı Sendromu Olan Hastalarda Omega-3 Kullanımının Hemodinamik ve Biyokimyasal Parametrelere Etkisinin Retrospektif Analizi. Sakarya Tıp Dergisi. December 2021;11(4):816-822. doi:10.31832/smj.927439

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