Omega-3 polyunsaturated fatty acids: benefit or harm during sepsis?

omega-3 polyunsaturated fatty acids (PUFAs) are potent modulators of the immune response. Their inclusion in enteral diets may benefit surgical patients recovering from injury or infection. Caution should be used when supplementing omega-3 PUFAs, particularly when fish oil is used as the source. The long-chain, highly polyunsaturated fatty acids in fish oil are prone to autoxidation, and can potentially damage cells by forming free radicals. In addition, fish oil may impair the hemostatic response by inhibiting platelet aggregation. Finally, the biochemical and biological end points for the use of omega-3 PUFAs have not been clearly established. Thus, although omega-3 PUFAs offer tremendous potential as immunomodulators, they also offer potential toxicities, and we must employ them in our clinical practice with this understanding.