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

Yıl 2021, Cilt: 11 Sayı: 4, 816 - 822, 27.12.2021
https://doi.org/10.31832/smj.927439

Öz

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.

Destekleyen Kurum

çalışmayı destekleyen kişi ya da kuruluşlar bulunmamaktadır.

Kaynakça

  • 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

Yıl 2021, Cilt: 11 Sayı: 4, 816 - 822, 27.12.2021
https://doi.org/10.31832/smj.927439

Öz

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.

Kaynakça

  • 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.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Sema Koçan 0000-0002-9049-3798

Leyla Kazancıoğlu 0000-0002-3833-0692

Yağmur Demirel 0000-0003-3877-3183

Canan Altınsoy 0000-0002-1188-0475

Yayımlanma Tarihi 27 Aralık 2021
Gönderilme Tarihi 25 Nisan 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 11 Sayı: 4

Kaynak Göster

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. Aralık 2021;11(4):816-822. doi:10.31832/smj.927439

30703

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