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  • 1
    Keywords: CANCER ; tumor ; CELL ; Germany ; liver ; SAMPLE ; SAMPLES ; TISSUE ; TUMORS ; SURGERY ; PATIENT ; IMPACT ; ACID ; ACIDS ; MALIGNANCIES ; PATTERNS ; PLASMA ; AGE ; GAS ; fatty acids ; DIET ; IMPROVES ; SMALL-INTESTINE ; nutrition ; COMPLICATIONS ; FATTY-ACID ; MALIGNANCY ; PATTERN ; FRACTION ; LEADS ; PHOSPHOLIPIDS ; WEIGHT ; SUPPLEMENTATION ; TUMOR TISSUE ; LEVEL ; methods ; PLASMA-LEVELS ; TISSUE SAMPLES ; USA ; phospholipid ; uptake ; EICOSAPENTAENOIC ACID ; ENTERAL NUTRITION ; EVALUATE ; GUT ; IMMUNONUTRITION ; MAJOR SURGERY ; PARENTERAL FISH-OIL ; POSTOPERATIVE TRAUMA ; TREATED RATS
    Abstract: Background: The uptake of omega-3 polyunsaturated fatty acids (PUFAs) into the liver, gut mucosa, and tumor tissue and plasma levels after preoperative administration of supplemented enteral nutrition was investigated in patients with malignancies of the upper gastrointestinal tract. The objective of the study was to evaluate the incorporation of preoperatively administrated PUFAs, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) into cell phospholipids. Methods: Patients undergoing major gastrointestinal surgery (n = 40) were prospectively randomized to receive a PUFA-supplemented liquid oral diet 5 days preoperatively or an isocaloric control diet. The planned diet intake was 1000 mL/d providing 3.7 g of PUFA. The diet was given in addition to the usual hospital diet. The phospholipid fractions in plasma were analyzed on the day of surgery. Tissue samples of liver, gut mucosa (small intestine), and tumor were taken during surgery and homogenized. EPA and DHA content was analyzed using liquid gas chromatography. Results: Both patient groups (PUFA group: n = 20; control group: n = 20) were similar in age, weight, and surgical procedures. As compared with the control group, the PUFA group had significantly increased levels of EPA in liver tissue (0.4 vs 1.3 weight %), gut mucosa (0.3 vs 1.0 weight %), and tumor tissue (0.3 vs 0.8 weight %). Also, the DHA levels in the PUFA group were significantly higher than the control group: liver tissue (4.1 vs 7.5 weight %), gut mucosa (2.1 vs 3.7 weight %) and tumor tissue (1.9 vs 4.2 weight %). Conclusions: This study suggests that administration of PUFA-enriched diets leads to increased incorporation of EPA and DHA not only in liver and gut mucosa tissue, but also in tumor tissue in patients with solid gastrointestinal tumors. Thus, preoperative administration of oral PUFA-enriched diets could have an impact on the postoperative inflammatory response after major abdominal surgery
    Type of Publication: Journal article published
    PubMed ID: 15961678
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  • 2
    Keywords: Germany ; METABOLISM ; SURGERY ; PATIENT ; SERA ; IMPACT ; treatment ; ACID ; ACIDS ; ERYTHROCYTES ; PLASMA ; MEMBRANE ; GAS ; PARAMETERS ; SAFETY ; DOUBLE-BLIND ; nutrition ; ARACHIDONIC-ACID ; MEMBRANES ; COMPLICATIONS ; SERUM ; PATTERN ; LEADS ; LEVEL ; methods ; EVENTS ; USA ; prospective ; uptake ; EICOSAPENTAENOIC ACID ; ENTERAL NUTRITION ; MAJOR SURGERY ; POSTOPERATIVE TRAUMA ; TREATED RATS ; DOCOSAHEXAENOIC ACID ; colorectal ; N-3 ; lipid ; polyunsaturated fatty acid ; ESTERS ; CARE UNIT ENVIRONMENT ; CONTAINING LIPID EMULSIONS ; FISH-OIL EMULSION
    Abstract: Background: The clinical safety and the uptake of omega-3 polyunsaturated fatty acids (PUFA) into the serum phospholipids and erythrocyte membranes after administration of fish-oil-supplemented parenteral nutrition (PN) was investigated in colorectal surgical patients. Methods: Forty patients undergoing colorectal surgery (n = 40) and with an indication for PN were enrolled in a prospective, double-blind, randomized study to receive an w-3 PUFA-supplemented 20% lipid emulsion (Lipoplus; B. Braun Melsungen, Melsungen, Germany; test group, n = 19) for 5 days postoperatively. The control group received a standard 20% fat emulsion (Lipofundin MCT/LCT, B. Braun Melsungen, Melsungen, Germany, control group, n = 21). Clinical outcome parameters and safety were assessed by means of adverse events recording clinical parameters and hematologic analyses. The contents of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), as well as arachidonic acid (AA), in phospholipid fractions in plasma and in erythrocytes were analyzed preoperatively, on postoperative days 1, 6, and 10 using liquid gas chromatography. Results: Both fat emulsions were well tolerated, and none of the adverse events was considered to be related to treatment. Postoperative infectious complications occurred in 4 patients of the w-3 PUFA group vs 7 patients in the control group. As compared with the control group, the w-3 PUFA group had significantly increased levels of EPA in the membranes of the erythrocytes in postoperative day 6 (2.0% +/- 0.9% vs 0.8% +/- 0.5% fatty acid methyl esters, [FAME]) and postoperative day 10 (2.1% +/- 0.8% vs 0.9% +/- 0.7% FAME, p 〈.05). Also, the EPA levels in the serum phospholipids were significantly higher than in the control group on the same postoperative days (7.0% +/- 2.6% vs 1.3% +/- 0.8% and 3.6% +/- 1.0% vs 1.0% 0.4% FAME, p 〈.05). The DHA levels in the serum phospholipids were significantly higher in the (o-3 PUFA group compared with the control on postoperative days 6 and 10 (11.8% +/- 1.9% vs 8.4% +/- 1.5% and 11.2% +/- 1.6% vs 8.5% +/- 1.4% FAME, p 〈.05). AA levels were not significantly different in the both groups. Conclusions: i2-3-fatty-acids-supplemented fat emulsions for parenteral administration are safe and very well tolerated. This study demonstrates that parenteral administration of omega-3-PUFA-enriched fat emulsions leads to increased incorporation of EPA and DHA into phospholipids in serum and erythrocytes, whereas AA levels remain unchanged. Thus, postoperative parenteral administration of omega-3-PUFA-enriched lipid emulsions could have an impact on the postoperative inflammatory response after abdominal surgery and could be used in standard postoperative care when PN is indicated
    Type of Publication: Journal article published
    PubMed ID: 17202435
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