The Treatment Effect Of Omega-3 Polyunsaturated Fatty Acids In Old Patients With Severe Pneumonia

BackgroundSevere pneumonia has an high incidence in infectious diseases.The disease progresses rapidly.A cascade of “falling inflammations” often occurs.Eventually it develops septic shock,systemic inflammatory response syndrome(SIRS),adult acute respiratory distress syndrome(ARDS),multiple organ dysfunction syndrome(MODS),the patient’s prognosis is poor,it is the main reason of death from infectious diseases.With the age rising,the deterioration of tissues and organs and the reduction of metabolic capacity,once respiratory infections occur,it is easy to progress to severe pneumonia.Severe pneumonia in elder age is gradually becoming the main type of disease in respiratory intensive care unit(RICU).About the treatment of severe pneumonia,it is important to study the mechanism of inflammatory reaction and the change of immune factors in severe pneumonia,and find new and effective treatment for severe pneumonia.In recent years,more and more scholars have begun to pay attention to the nutritional support of critically ill patients.Nutritional support treatment can provide the necessary energy and nutrient substrates for cell metabolism,reduce the damage of tissue cells,maintain the structure and function of tissues and organs,and thus affect the disease.With the development of immune nutriology,it has gradually been emphasized by down-regulating inflammatory responses and improving immune function.ω-3 polyunsaturated fatty acids is a kind of pharmacological nutrients that can regulate inflammation and immune function of the body through various ways,reduce the production of cytokines and release of inflammatory mediators,maintain moderate immune responses,and reduce excessive inflammatory responses.Studies have shown that trauma,infection,severe pancreatitis,and ALI/ARDS supplementation with a pharmacological dose of ω-3 polyunsaturated fatty acids may have beneficial effects in improving oxygenation,shortening mechanical ventilation time,and staying in the ICU.For the elderly patients with severe pneumonia,use of pharmacologically measured ω-3 polyunsaturated fatty acids may have a beneficial effect on their inflammatory response and immune function.AimWe observed the patients with severe pneumonia in elderly patients,examined the changes in general,inflammatory factors,immune parameters,and prognostic indicators before and after treatment.To investigate the therapeutic value of ω-3 polyunsaturated fatty acids in elderly severe pneumonia,and to provide theoretical basis for the diagnosis and treatment of severe pneumonia.Method1.It is a retrospective analysis of 92 elderly patients with severe pneumonia who visited The First Affiliated Hospital of Zhengzhou University from January 2016 to September 2017.2.All the enrolled patients met the diagnostic criteria for severe acute pneumonia in the Guidelines for the Diagnosis and Treatment of Adult Communicable Acquired Pneumonia of the Chinese Society of Respiratory Diseases in April 2016.3.The 92 patients enrolled were divided into experimental group(n=58)and control group(n=34).All of them were given early enteral nutrition,the experimental group contained ω-3 polyunsaturated fatty acids in the nutrient solution.Treatment is based on expert consensus and treatment guidelines for severe pneumonia,including anti-infection,anti-shock,oxygen therapy,correction of internal environmental disorders,vital signs monitoring,symptomatic support etc.Depending on the condition,it is necessary to give endotracheal intubation,mechanical ventilation and vasoactive drugs,antibiotics are based on clinical experience and the results of bacterial susceptibility testing.4.Collecting the inflammatory response : IL-1,IL-6,IL-10,TNF-α,CRP;immune function indicators:CD3+,CD4+,CD8+,CD4+/CD8+ratios,general conditions,Long-term prognosis indicators,before and after treatment.The changes of each index in the two groups of patients were compared,research the function of ω-3 polyunsaturated fatty acids in the treatment of severe pneumonia.Result1.After 5 days treatment,the general conditions of the two groups were improved(P<0.05).The heart rate and respiratory rate of experimental group were superior than that the control group(P<0.05),but the temperature、oxygen index were not improved than that the control group(P>0.05).2.After 5 days treatment,the levels of CRP,IL-1,IL-6,IL-10 and TNF-α in two groups were better than before(P<0.05).The experimental group had better levels of IL-10,IL-6 and TNF-α(P<0.05),but not in CRP,IL-1(P>0.05).3.After 5 days treatment,two groups CD3+,CD4+,CD8+ and CD4+/CD8+ ratios were better than before(P<0.05),and the experimental group CD3+ was superior than the control group(P<0.05),but CD4+,CD8+ and CD4+/CD8+ ratios were not superior than that the control group(P>0.05).4.Compared with the control group,the mechanical ventilation and ICU stay time in the experimental group were shortened(P<0.05).The incidence of MODS,success rate of take off the ventilator and 28-day mortality difference was not statistically significant(P>0.05).Conclusionω-3 polyunsaturated fatty acids early enteral nutrition can better reduce the inflammatory response in elderly patients with severe pneumonia,shorten mechanical ventilation and ICU stay time.