Vanzant Erin, Loftus Tyler, Kamel Amir, Carmichael Ethan, Rosenthal Martin D
Division of Trauma and Acute Care Surgery, Department of Surgery, College of Medicine, University of Florida.
Department of Pharmacy, UF Health Shands Hospital, University of Florida College of Pharmacy, Gainesville, Florida, USA.
Curr Opin Clin Nutr Metab Care. 2022 Mar 1;25(2):75-80. doi: 10.1097/MCO.0000000000000818.
Lipids have been utilized historically as a calorie dense means to ensure delivery of essential fatty acids (FA). Since the development of mixed lipid emulsion and investigation of immunomodulatory formulas, there has been an awakening that not all lipids are created equal. This narrative review focuses on contemporary evidence in the utilization of lipids (namely omega 3 fatty acids) in both acute and chronic critical illness.
Though randomized control trials and meta-analyses provide little guidance regarding clinical practice for patients suffering from chronic critical illness, available literature suggests the potential to use lipid formulas to decrease the inflammatory cycle that drives catabolism. Additionally, this review will address the expanding evidence that specialized pro-resolving mediators (SPMs) may be the future of immunomodulating inflammation in acute and chronic critical illness and the persistent inflammation, immunosuppression, and catabolic syndrome (PICS).
Although societal guidelines, expert consensus, and literature support the use of omega 3 fatty acids in the acute critically ill population, more research is needed regarding omega 3 fatty acids for chronic critical illness and PICS.
历史上，脂质一直被用作一种高热量手段，以确保必需脂肪酸（FA）的供应。自从混合脂质乳剂的开发以及对免疫调节配方的研究以来，人们开始意识到并非所有脂质都是相同的。这篇叙述性综述聚焦于脂质（即ω-3脂肪酸）在急性和慢性危重症中应用的当代证据。
尽管随机对照试验和荟萃分析对慢性危重症患者的临床实践指导作用不大，但现有文献表明，使用脂质配方有可能减少驱动分解代谢的炎症循环。此外，本综述将探讨越来越多的证据，即特殊促解决介质（SPM）可能是急性和慢性危重症以及持续性炎症、免疫抑制和分解代谢综合征（PICS）中免疫调节炎症的未来发展方向。
尽管社会指南、专家共识和文献支持在急性危重症人群中使用ω-3脂肪酸，但对于慢性危重症和PICS患者使用ω-3脂肪酸仍需要更多研究。
