Enteral Support and N-3 Fatty Acids in Critically Ill Elderly Patients

  • Karina V. Barros
  • Ana Paula Cassulino
  • Vera Lúcia Flor Silveira
Reference work entry


Ageing is characterized by a series of physiological and psychological changes that are related, in turn, with alterations in the nutritional status. The human immune system progressively deteriorates with age, leading to a greater incidence or the reactivation of infectious diseases, as well as to the development of autoimmune disorders and cancer.

The critically ill elderly are more likely to suffer an exacerbated inflammatory response increasing the susceptibility of infection, sepsis, septic shock and multiple organ failure development, which are related to a longer hospitalization period and elevated risk of mortality.

The relationship between inflammatory response and polyunsaturated fatty acids (PUFA)–enriched diets has been investigated in last years. Several studies have shown that PUFA can modify immunological and inflammatory reactions and can be used as a complementary therapy in chronic diseases. Enteral formulas supplied with specific pharmaconutrients can help offset tissue damage and moderate the inflammation.

In this sense, n-3 PUFA intake can alter the fatty acid composition in membranes of cells involved in immune inflammatory responses and leading to better outcomes. Several clinical studies have shown that the administration of n-3 PUFA can blunt the inflammatory response in critically ill patients.

Although n-3 PUFA as pharmaconutrition appears to exert beneficial effects with no side effects, enteral supplementation of this fatty acid has presented conflicting data in the literature. These discordant data are most likely due to different routes of administration (enteral or parenteral), dose, duration of administration, timing of onset in relation to stage of the inflammatory response and differences in the nutrient combinations used. Further researches are necessary before any definitive recommendations can be made about enteral n-3 PUFA supplementation in critically ill patients, mainly in special populations, such as the elderly.

This chapter will focus on the literature review about the critically ill elderly, inflammation, fatty acids and n-3 PUFA supplementation in enteral nutrition.


Intensive Care Unit Parenteral Nutrition Intensive Care Unit Patient Enteral Nutrition Intensive Care Unit Stay 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations


Arachidonic acid


α-linolenic acid


Antigen presenting cells


American society of parenteral and enteral nutrition


Cardiovascular disease


Delta-5-desaturases enzyme


Delta-6-desaturases enzyme


Docosapentaenoic acid


European Food and Safety Authority (EFSA)


Eicosapentaenoic acid


European society of parenteral and enteral nutrition


Fatty acids


Food and Drug Administration


Gamma linolenic acid


Intercellular adhesion molecule


Intensive care unit




Linoleic acid


National heart foundation


National Healthy of Medical Research Council (NHMRC)


Plasma phosphatidylcholine


Polyunsaturated fatty acids


Reactive oxygen species


Single nucleotide polymorphism


Tumor necrose factor


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Karina V. Barros
    • 1
  • Ana Paula Cassulino
    • 1
  • Vera Lúcia Flor Silveira
    • 2
  1. 1.Departamento de FisiologiaUniversidade Federal de São Paulo-Campus São PauloSão PauloBrazil
  2. 2.Departamento de Ciências BiológicasUniversidade Federal de São Paulo-Campus DiademaEldorado, DiademaBrazil

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