期刊
CRITICAL CARE MEDICINE
卷 28, 期 5, 页码 1489-1496出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00003246-200005000-00039
关键词
fish oil; soybean oil; omega-3 fatty acids; omega-6 fatty acids; parenteral nutrition; eicosanoids; endotoxin; organ blood flow; splanchnic perfusion; microbial translocation
Objective: Intestinal ischemia decreases barrier function of the gut and enhances translocation of bacteria and toxins, Several studies indicate that fish oil can modulate prostaglandin formation and thus, regional blood how and immune function. This study was performed to determine the effects of parenteral diets with omega-3 fatty acids on microcirculation and barrier function of the gut. Design: Prospective, randomized, controlled animal study. Setting: University laboratory. Subjects: A total of 64 male Sprague-Dawley CD rats. Interventions and Measurements: For 48 hrs, eight groups of eight rats each received total parenteral nutrition with four different types of lipids. The source of fat in group L was soybean oil only and in group L-M a mixture of soybean oil and medium-chain triglycerides. In groups FO-20 and FO-40, 20% or 40%, respectively, of the soybean oil in group L-M was replaced by fish oil. The other four groups received an additional continuous infusion of endotoxin (0.1 mg/100 g body weight per day) for the last 24 hrs. Blood flow was measured with microspheres, and translocation was determined by microbiological methods and instillation of radioactive-marked bacteria into the gut. Main Results: In the animals without fish oil, the endotoxin application reduced the blood flow to the intestine similar to 25%. Animals with fish oil in their diets showed normal values. Translocation of gut bacteria was increased significantly in all endotoxin groups. However, less-viable bacteria could be detected in the animals with fish oil diets in their mesenteric lymph nodes and livers. Conclusions: In this model, diets enriched with fish oil abolish the endotoxin-induced decrease of nutritive blood flow to the gut and ameliorate the bactericidal defense of the splanchnic region. The lower count of viable bacteria in the fish oil groups is more related to an improved killing of translocated bacteria than a reduction of the translocation rate.
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