• Teodoro Grau-Carmona, Alfonso Bonet-Saris, Abelardo García-de-Lorenzo, Carmen Sánchez-Alvarez, Angel Rodríguez-Pozo, José Acosta-Escribano, Eduardo Miñambres, Jose Ignacio Herrero-Meseguer, and Alfonso Mesejo.
• 1Intensive Care Unit, Hospital Universitario Doce de Octubre, Madrid, Spain. 2Intensive Care Unit, Clinica Girona, Girona, Spain. 3Intensive Care Unit, Hospital Universitario La Paz, Madrid, Spain. 4Intensive Care Unit, Hospital General Universitario Reina Sofía, Murcia, Spain. 5Intensive Care Unit, Hospital Universitari Arnau de Vilanova, Lleida, Spain. 6Intensive Care Unit, Hospital General Universitario de Alicante, Alicante, Spain 7Intensive Care Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 8Intensive Care Unit, Hospital Universitario de Bellvitge, Barcelona, Spain. 9Intensive Care Unit, Hospital Clinico Universitario, Valencia, Spain.
• Crit. Care Med. 2015 Jan 1; 43 (1): 31-9.

Objectiven-3 polyunsaturated fatty acids (contained in fish oil) have been shown to beneficially influence infection rate and clinical outcomes in surgical patients probably due to their immunomodulatory action. In contrast, study results of fish oil administration in critically ill patients are controversial. The aim of this study was to investigate the effects of n-3 polyunsaturated fatty acids on the prevalence of nosocomial infections and clinical outcomes in medical and surgical critically ill patients.DesignProspective, multicenter, randomized, comparative, double-blind study.SettingSeventeen Spanish ICUs during 4 years.SubjectsA total of 159 medical and surgical intensive care patients with Acute Physiology and Chronic Health Evaluation II score more than or equal to 13, expected to require total parenteral nutrition for at least 5 days.InterventionsPatients received total parenteral nutrition prepared either with a lipid emulsion containing 10% fish oil or a fish oil-free lipid emulsion. The prevalence of nosocomial infections was detected during 28 days of ICU stay. Patients were followed 6 months after discharge from the ICU for length of hospital stay, hospital mortality, and 6-month mortality.Measurements And Main ResultsThe number of patients with nosocomial infections was significantly reduced in the fish oil-receiving group (21.0% vs 37.2%, p = 0.035) and the predicted time free of infection was prolonged (21 ± 2 vs 16 ± 2 d, p = 0.03). No significant differences were detected for ICU, hospital, and 6-month mortality.ConclusionsThe results show that administration of n-3 polyunsaturated fatty acids reduces the risk of nosocomial infections and increases the predicted time free of infections in critically ill medical and surgical patients. The administration of n-3 polyunsaturated fatty acids was safe and well tolerated.

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