Randomized, double blind, placebo-controlled trial of fish-oil-based lipid emulsion infusion for treatment of critically ill patients with severe sepsis

OBJECTIVE: The present study aimed to determine the clinical benefits to critically ill patients with severe sepsis of receiving parenteral fish-oil-based lipid emulsion as adjuvant treatment. METHODS: This was a prospective, randomized, double-blind, placebo-controlled clinical trial of 28 patients with severe sepsis in the intensive care unit of a primary and referral teaching hospital. RESULTS: Fourteen patients were randomly assigned to the study group and a similar number were placed in the control group. The study group showed a significant score reduction for Acute Physiology and Chronic Health Evaluation (APACHE) II on day 3 (p = 0.004), day 5 (p = 0.032) and day 7 (p = 0.03), together with APACHE III (p = 0.028) and Simplified Acute Physiology Score II (p = 0.019) on day 7. The serum procalcitonin level was significantly decreased in the study group on day 3 (p = 0.018), day 5 (p = 0.011) and day 7 (p = 0.028). However, the serum tumour necrosis factor-á level, length of intensive care unit and hospital stay showed no significant difference when the groups were compared. CONCLUSION: Adjuvant treatment with fish-oil-based lipid emulsion of 10% Omegaven for critically ill patients with severe sepsis is probably safe and helpful for rapid reduction of clinical severity of the disease.