The Clinical Effect Of Omega-3 Polyunsaturated Fatty Acids In Patients With Abdominal Sepsis

Objective: With the progress of science, the research and exploration in the etiology and pathogenesis of sepsis has grown deeper. Sepsis is one of the main causes of death in critically ill patients, and its pathogenesis is complex, which is not only related to the primary disease, but also bound up with the bacterial endotoxin, inflammation, coagulation abnormalities, neuroregu- lation and endocrine adjustment disorder, immune dysfunction, intestinal bacterial translocation and gene polymorphism. In recent years, some studies have shown that immune adjustment disorder plays an significant role in pathophysiological changes of sepsis, especially in severe sepsis and multiple organ dysfunction syndrome(MODS), directly impacting the development and prognosis of disease. Therefore, it is a new idea to treat sepsis by using immune nutrition to regulate systemic infections and recovery the balance between pro-inflammatory and anti-inflammatory. As one of the important representatives of immunonutrient pharmaceutic, Omega-3 polyunsaturated fatty acids(ω-3PAFUs) has attracted much attention in the field of immunonutrition research recently, which not only can provide the body with energy and metabolic substrate, but also can regulate the body’s inflammatory reaction, adjust blood glucose lipid abnormalities, and improve prognosis. This study aimed to observe the therapeutic effect of ω-3PAFUS for nutrition support in patients with abdominal sepsis.Methods: 63 patients with abdominal sepsis were randomly assigned into study group(30 cases) and control group(33 cases), selected from emergency intensive care unit(EICU) of the Second Hospital of Hebei Medical University from December 2012 to December 2014. All patients received the same basic treatment and the isocaloric and isonitrogenous total parenteral nutrition(TPN). And ω-3PAFUS(made in huarui company) 0.2 g/kg/d was added to the study group to replace part of structure fat emulsion lasting 5 days. Other foundation treatments were same between groups, following the international guidelines of severe sepsis and septic shock in 2012. The concentrations of serum ALB,PA,WBC,CRP,PCT,D-lactic acid,TNF-а,IL-1,IL-6,OI and HMGB-1were detected before and 3,6 days after treatment in both groups. Score of APACHE Ⅱ, length of ICU stay, mechanical ventilation time and continuous hemofiltration treatment time,and 28-day mortality were recorded after treatment. Statistical analysis was performed by SPSS13.0 statistical software.Results: Before TPN treatment, there is no statistically significant difference in gender, age, body mass index(BMI), disease category or acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score between the two groups. After TPN treatment 3, 6 days, compared with the control group, the concentrations of serum ALB,PA and OI were obviously improved,and concentrations of serum CRP, PCT, D-lactic acid, TNF-a, IL-1,IL-6,HMGB-1 were significantly lower in the study group(P<0.05). The length of ICU stay was significantly shorter than the control group(P<0.05). Although scores of APACHE Ⅱ, mechanical ventilation time or continuous hemofiltration treatment time and 28-day mortality were decreased than the control group after treatment, there was no statistically significant difference between the two groups(P > 0.05).Conclusions: Applied in patients with abdominal sepsis, ω-3PAFUS is considered as one kind of effective immunonutrient pharmaceutics which can improve nutritional condition, reduce the release of inflammatory mediators,control inflammatory reaction and improve immunity, also can shorten the length of ICU stay.