Nutrition Service, Alberta Health Services, Edmonton Area, Canada.
Clin Nutr. 2012 Jun;31(3):322-9. doi: 10.1016/j.clnu.2011.11.006. Epub 2011 Dec 3.
BACKGROUND & AIMS: This study assessed the effects of administering a lipid emulsion containing eicosapentaenoic and docosahexaenoic acid before and after open-heart surgery on cytokine production and length of hospital stay in infants.
Thirty-two infants (40 ± 2.3 weeks gestational age; 10.6 days at time of surgery) undergoing open-heart surgery with cardiopulmonary bypass were randomized to receive an intravenous lipid emulsion with (treatment) or without (control) eicosapentaenoic and docosahexaenoic acid in this prospective, randomized, double-blind, controlled trial.
Mean plasma TNF-α concentration was significantly (p = 0.003) lower in the treatment (5.9 pg/mL) compared to the control group (14.8 pg/mL). In infants without sepsis, plasma TNF-α did not differ according to treatment, however when sepsis developed, mean plasma TNF-α was 21.1 pg/mL and 1.5 pg/mL (p = 0.0007) in control and treatment groups, respectively. Plasma TNF-α was positively correlated with length of hospital stay in the control group (p = 0.01), and negatively correlated with length of stay in the treatment group (p = 0.004), with a significant time by treatment interaction (p = 0.02).
Providing a lipid emulsion containing eicosapentaenoic and docosahexaenoic acid reduces TNF-α concentrations in infants undergoing open-heart surgery. Lipid emulsions containing eicosapentaenoic and docosahexaenoic acid may ameliorate the inflammatory response among critically ill infants.
本研究评估了在体外循环心脏直视手术后给予含二十碳五烯酸和二十二碳六烯酸的脂肪乳剂对婴儿细胞因子产生和住院时间的影响。
32 名（胎龄 40 ± 2.3 周；手术时 10.6 天）接受体外循环心脏直视手术的婴儿被随机分为接受含二十碳五烯酸和二十二碳六烯酸的静脉脂肪乳剂（治疗组）或不含二十碳五烯酸和二十二碳六烯酸的静脉脂肪乳剂（对照组）的前瞻性、随机、双盲、对照试验。
治疗组（5.9 pg/mL）的平均血浆 TNF-α 浓度明显（p = 0.003）低于对照组（14.8 pg/mL）。在没有败血症的婴儿中，血浆 TNF-α 不受治疗的影响，但当发生败血症时，对照组和治疗组的平均血浆 TNF-α 分别为 21.1 pg/mL 和 1.5 pg/mL（p = 0.0007）。血浆 TNF-α与对照组住院时间呈正相关（p = 0.01），与治疗组住院时间呈负相关（p = 0.004），治疗时间存在显著的相互作用（p = 0.02）。
提供含二十碳五烯酸和二十二碳六烯酸的脂肪乳剂可降低接受心脏直视手术的婴儿的 TNF-α 浓度。含二十碳五烯酸和二十二碳六烯酸的脂肪乳剂可能改善危重症婴儿的炎症反应。
