A Randomized Controlled Trial Investigating the Effects of Parenteral Fish Oil on Survival Outcomes in Critically Ill Patients With Sepsis: A Pilot Study

Introduction: Death from sepsis in the intensive care unit (ITU) is frequently preceded by the development of multiple organ failure as a result of uncontrolled inflammation. Treatment with -3 has been demonstrated to attenuate the effects of uncontrolled inflammation and may be clinically beneficial. Method: A randomized control trial investigating the effects of parenteral -3 was carried out. Consecutive patients diagnosed with sepsis were entered into the study and randomized to receive either parenteral -3 or standard medical care only. The primary outcome measure was a reduction in organ dysfunction using the Sequential Organ Failure Assessment (SOFA) score as a surrogate marker. The secondary outcome measures were mortality, length of stay, mean C-reactive protein (CRP), and days free of organ dysfunction/failure. Results: Sixty patients were included in the study. The baseline demographics were matched for the two cohorts. Patients treated with parenteral -3 were associated with a significant reduction in new organ dysfunction (-SOFA 2.2 +/- 2.2 vs. 1.0 +/- 1.5, P = .005 and maximum-SOFA 10.1 +/- 4.2 vs. 8.1 +/- 3.2, P = .041) and maximum CRP (186.7 +/- 78 vs. 141.5 +/- 62.6, P = .019). There was no significant reduction in the length of stay between cohorts. Patients treated with -3 in the strata of less severe sepsis had a significant reduction in mortality (P = .042). Conclusion: The treatment of critically ill septic patients with parenteral -3 is safe. It is associated with a significant reduction in organ dysfunction. It may be associated with a reduction in mortality in patients with less severe sepsis.