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Intensive Care Medicine

, Volume 36, Issue 2, pp 289–295 | Cite as

Blunting the response to endotoxin in healthy subjects: effects of various doses of intravenous fish oil

  • Yann K. Pittet
  • Mette M. BergerEmail author
  • Thomas-Thi Pluess
  • Pierre Voirol
  • Jean-Pierre Revelly
  • Luc Tappy
  • René L. Chioléro
Original

Abstract

Objective

To test the dose response effect of infused fish oil (FO) rich in n-3 PUFAs on the inflammatory response to endotoxin (LPS) and on membrane incorporation of fatty acids in healthy subjects.

Design

Prospective, sequential investigation comparing three different FO doses.

Subjects

Three groups of male subjects aged 26.8 ± 3.2 years (BMI 22.5 ± 2.1).

Intervention

One of three FO doses (Omegaven®10%) as a slow infusion before LPS: 0.5 g/kg 1 day before LPS, 0.2 g/kg 1 day before, or 0.2 g/kg 2 h before.

Measurements and results

Temperature, hemodynamic variables, indirect calorimetry and blood samples (TNF-α, stress hormones) were collected. After LPS temperature, ACTH and TNF-α concentrations increased in the three groups: the responses were significantly blunted (p < 0.0001) compared with the control group of the Pluess et al. trial. Cortisol was unchanged. Lowest plasma ACTH, TNF-α and temperature AUC values were observed after a single 0.2 g/kg dose of FO. EPA incorporation into platelet membranes was dose-dependent.

Conclusions

Having previously shown that the response to LPS was reproducible, this study shows that three FO doses blunted it to various degrees. The 0.2 g/kg perfusion immediately before LPS was the most efficient in blunting the responses, suggesting LPS capture in addition to the systemic and membrane effects.

Keywords

Inflammation Sepsis PUFA Downregulation 

Notes

Acknowledgments

We are grateful to Prof. Yvon Carpentier and his team (NUTRISUB Laboratory ULB, Brussels, Belgium) for the determinations of the fatty acid membrane incorporation and to Dr. Christiane Ruffieux and Pierre Bady (Institute of Social and Preventive Medicine, University of Lausanne) for statistical advice. The study was primarily supported by a grant from the Swiss National Science Foundation (no. 32-61582.00) and completed by a partial grant from Fresenius Kabi AG (Bad Homburg, Germany) for laboratory determinations.

Conflict of interest statement

None of the authors has any conflict of interest, such as bonds, or any economic implications in the industry. R.L. Chiolero and M.M. Berger deliver invited lectures for Fresenius Kabi AG, B. Braun and Nestlé. The groups research is partially supported by grants from Fresenius Kabi AG and B. Braun.

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Copyright information

© Copyright jointly hold by Springer and ESICM 2009

Authors and Affiliations

  • Yann K. Pittet
    • 1
  • Mette M. Berger
    • 1
    Email author
  • Thomas-Thi Pluess
    • 1
  • Pierre Voirol
    • 2
  • Jean-Pierre Revelly
    • 1
  • Luc Tappy
    • 3
  • René L. Chioléro
    • 1
  1. 1.Service of Adult Intensive Care Medicine and Burns CentreCHUVLausanneSwitzerland
  2. 2.PharmacyCHUVLausanneSwitzerland
  3. 3.Institute of PhysiologyUNILLausanneSwitzerland

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