Impact of the ratio of intravenous omega-3 vs. omega-6 polyunsaturated fatty acids in postoperative and in septic patients—A post hoc database analysis

SummaryBackground & aimsOmega-3 fatty acids (FA) have been shown to reduce morbidity and mortality. Aim of this study was to evaluate acute effects in a multicenter database with regard to outcome arising from varying ratios of omega-3 vs. omega-6 FA independent from the underlying dose of eicosapentaenoic acid or docosahexaenoic acid.MethodsSix hundred and sixty-one patients from 82 German hospitals receiving total parenteral nutrition including fish oil for at least 3 consecutive days participated in this study. The sample included 255 patients after major abdominal surgery and 276 with peritonitis and abdominal sepsis. Length of stay and use of antibiotics were analyzed with respect to their diagnosis.ResultsA mean dose of eicosapentaenoic and docosahexaenoic acid of 56±16 mg/kg/d was infused. Most favorable effects on length of ICU stay were observed when the omega-3/omega-6 ratio was <1:2. In patients with abdominal sepsis receiving an omega-3/omega-6 ratio of 7.5:1 antibiotic demand was significantly reduced by 42–50% and length of ICU stay was significantly prolonged in septic patients when the ratio was 1:1.ConclusionDespite the present post-hoc evaluation merely allows hypotheses generating conclusions, the omega-3/omega-6 ratio diagnosis dependently affected clinical outcome in a large number of patients independent from the fish oil dosage. At a given dosage an omega-3/omega-6 FA ratio of <1:1 may be associated with a shorter length of ICU stay in septic patients.