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Pharmacokinetics of Omega-3 Fatty Acids in Patients with Severe Sepsis Compared with Healthy Volunteers: A Prospective Cohort Study

Radhika Parikh, J. Bates, M. Poynter, B. Suratt, Polly E. Parsons, C. Kien, D. Heyland, Karen I. Crain et al.

Clinical Nutrition, 2019

15 participants · 16 citations

Abstract

Background: Pharmacokinetics (PK) of pharmaceuticals and pharmaconutrients are poorly understood in critically ill patients, and dosing is often based on healthy subject data. This might be particularly problematic with enteral medications due to metabolic abnormalities and impaired gastrointestinal tract absorption common in critically ill patients. Utilizing enteral fish oil, this study was undertaken to better understand and define PK of enteral omega-3 fatty acids (eicospentaenoic acid [EPA] and docosahexaenoic acid [DHA]) in critically ill patients with severe sepsis. Materials and Methods: Healthy volunteers (n=15) and mechanically ventilated (MV) adults with severe sepsis (n=10) were recruited and received 9.75g EPA and 6.75g DHA daily in two divided enteral doses of fish oil for 7 days. Volunteers continued their normal diet without other sources of fish oil, and sepsis patients received standard enteral feeding. Blood was collected at frequent intervals during the 14-day study period. Peripheral blood mononuclear cells (PMBCs) and neutrophils were isolated and analyzed for membrane fatty acid (FA) content. Mixed linear models and t-tests were used to analyze changes in FA levels over time and FA levels at individual time points, respectively. PK parameters were obtained based on single compartment models of EPA and DHA kinetics. Results: Healthy volunteers were 41.1±10.3 years; 67% were women. In patients with severe sepsis (55.6±13.4 years, 50% women), acute…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 15 participants or records.

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