Lege Artis Medicinae

[ENTERAL ADMINISTRATION OF N-3 POLYUNSATURATED FATTY ACIDS IN ACUTE PANCREATITIS]

LÁSZTITY Natália, HAMVAS József, BÍRÓ Lajos, NÉMETH Éva, MAROSVÖLGYI Tamás, DECSI Tamás, PAP Ákos, ANTAL Magda

OCTOBER 18, 2006

Lege Artis Medicinae - 2006;16(10)

[BACKGROUND - The main determinant of outcome in acute pancreatitis is the extent of inflammation and pancreatic necrosis. Early administration of n-3 polyunsaturated fatty acids (PUFAs) may prevent the development of severe complications through modulation of eicosanoid synthesis and cytokine release. PATIENTS AND METHODS - In the prospective, randomised clinical trial 14 patients with acute pancreatitis received n-3 PUFAs (3.3 g/day for 5- 7 days) as a supplement to their enteral formula in the form of fish oil, and another 14 patients receiving enteral nutrition served as a control group. Measurements of erythrocyte superoxidedysmutase activity, serum total antioxidant status, C-reactive protein and praealbumin concentrations were performed at admission and at day 3, 7 and 14. Beside routine laboratory and imaging examinations, the fatty acid and vitamin A and E concentrations of the serum lipid fractions were also determined at admission and at day 7 of the jejunal nutrition. The endpoints of the study were the duration of hospitalisation, the duration of jejunal nutrition and the frequency of complications. RESULTS - A significantly higher superoxidedysmutase activity was observed in patients receiving n-3 fatty acids at day 3 of the treatment. The n-3 to n-6 long chain PUFA ratio increased significantly in the serum lipids of the patients receiving n-3 PUFA supplementation, whereas remained unchanged in the controls. Supplementation resulted in a significant decrease in the length of hospitalisation (13.1±6.7 vs. 19.3±7.2 days, p<0.05) and jejunal feeding (10.6±6.7 vs. 17.6±10.5, p<0.05). Complications developed in 6/14 (42%) of the treated group and in 9/14 (64%) of the control patients. CONCLUSION - Enteral administration of n-3 PUFAs in acute pancreatitis may promote earlier recovery by moderating inflammation.]

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