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The Role of Omega-3 Polyunsaturated Fatty Acids in the Treatment of Patients with Acute Respiratory Distress Syndrome: A Clinical Review.

García de Acilu M, Leal S, Caralt B, Roca O, Sabater J, Masclans JR - Biomed Res Int (2015)

Bottom Line: Acute respiratory distress syndrome (ARDS) is defined as the acute onset of noncardiogenic edema and subsequent gas-exchange impairment due to a severe inflammatory process.The use of enteral diets enriched with eicosapentaenoic acid (EPA) and gamma-linolenic acid (GLA) has reported promising results, showing an improvement in respiratory variables and haemodynamics.However, the interpretation of the studies is limited by their heterogeneity and methodology and the effect of ω-3 fatty acid-enriched lipid emulsion or enteral diets on patients with ARDS remains unclear.

View Article: PubMed Central - PubMed

Affiliation: Critical Care Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, 08035 Barcelona, Spain.

ABSTRACT
Acute respiratory distress syndrome (ARDS) is defined as the acute onset of noncardiogenic edema and subsequent gas-exchange impairment due to a severe inflammatory process. Recent report on the prognostic value of eicosanoids in patients with ARDS suggests that modulating the inflammatory response through the use of polyunsaturated fatty acids may be a useful strategy for ARDS treatment. The use of enteral diets enriched with eicosapentaenoic acid (EPA) and gamma-linolenic acid (GLA) has reported promising results, showing an improvement in respiratory variables and haemodynamics. However, the interpretation of the studies is limited by their heterogeneity and methodology and the effect of ω-3 fatty acid-enriched lipid emulsion or enteral diets on patients with ARDS remains unclear. Therefore, the routine use of ω-3 fatty acid-enriched nutrition cannot be recommended and further large, homogeneous, and high-quality clinical trials need to be conducted to clarify the effectiveness of ω-3 polyunsaturated fatty acids.

No MeSH data available.


Related in: MedlinePlus

Effects of ω-3 polyunsaturated fatty acids in ARDS.
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Related In: Results  -  Collection


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fig2: Effects of ω-3 polyunsaturated fatty acids in ARDS.

Mentions: Fatty acids are crucial to human life: they are a main source of energy, they have structural functions as part of the cell membrane, and they participate in cell signalling and response [23]. Essential polyunsaturated fatty acids (PUFA) are linoleic acid (LA, PUFA ω-6 series) and linolenic acid (LNA, PUFA ω-3 series), which must be obtained through the diet. Linoleic acid is the endogenous precursor of arachidonic acid (AA), which joins the phospholipids in the cell membrane, while LNA is related to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). However, direct ingestion of these acids (from fish, shellfish, and algae) seems to be a more efficient source. Oxygenation and lipoxygenase enzymes transform AA into eicosanoids such as prostaglandins, thromboxanes, and leukotrienes, which have a high biological activity and play a major role in the inflammatory response (Figure 1). In contrast, LNA derivatives are much less active. As they both use the same metabolic routes, ω-3 fatty acids compete with AA for the conversion to lipid mediators, balancing the negative effects of ω-6 fatty acids [24] (Figure 2).


The Role of Omega-3 Polyunsaturated Fatty Acids in the Treatment of Patients with Acute Respiratory Distress Syndrome: A Clinical Review.

García de Acilu M, Leal S, Caralt B, Roca O, Sabater J, Masclans JR - Biomed Res Int (2015)

Effects of ω-3 polyunsaturated fatty acids in ARDS.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4538316&req=5

fig2: Effects of ω-3 polyunsaturated fatty acids in ARDS.
Mentions: Fatty acids are crucial to human life: they are a main source of energy, they have structural functions as part of the cell membrane, and they participate in cell signalling and response [23]. Essential polyunsaturated fatty acids (PUFA) are linoleic acid (LA, PUFA ω-6 series) and linolenic acid (LNA, PUFA ω-3 series), which must be obtained through the diet. Linoleic acid is the endogenous precursor of arachidonic acid (AA), which joins the phospholipids in the cell membrane, while LNA is related to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). However, direct ingestion of these acids (from fish, shellfish, and algae) seems to be a more efficient source. Oxygenation and lipoxygenase enzymes transform AA into eicosanoids such as prostaglandins, thromboxanes, and leukotrienes, which have a high biological activity and play a major role in the inflammatory response (Figure 1). In contrast, LNA derivatives are much less active. As they both use the same metabolic routes, ω-3 fatty acids compete with AA for the conversion to lipid mediators, balancing the negative effects of ω-6 fatty acids [24] (Figure 2).

Bottom Line: Acute respiratory distress syndrome (ARDS) is defined as the acute onset of noncardiogenic edema and subsequent gas-exchange impairment due to a severe inflammatory process.The use of enteral diets enriched with eicosapentaenoic acid (EPA) and gamma-linolenic acid (GLA) has reported promising results, showing an improvement in respiratory variables and haemodynamics.However, the interpretation of the studies is limited by their heterogeneity and methodology and the effect of ω-3 fatty acid-enriched lipid emulsion or enteral diets on patients with ARDS remains unclear.

View Article: PubMed Central - PubMed

Affiliation: Critical Care Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, 08035 Barcelona, Spain.

ABSTRACT
Acute respiratory distress syndrome (ARDS) is defined as the acute onset of noncardiogenic edema and subsequent gas-exchange impairment due to a severe inflammatory process. Recent report on the prognostic value of eicosanoids in patients with ARDS suggests that modulating the inflammatory response through the use of polyunsaturated fatty acids may be a useful strategy for ARDS treatment. The use of enteral diets enriched with eicosapentaenoic acid (EPA) and gamma-linolenic acid (GLA) has reported promising results, showing an improvement in respiratory variables and haemodynamics. However, the interpretation of the studies is limited by their heterogeneity and methodology and the effect of ω-3 fatty acid-enriched lipid emulsion or enteral diets on patients with ARDS remains unclear. Therefore, the routine use of ω-3 fatty acid-enriched nutrition cannot be recommended and further large, homogeneous, and high-quality clinical trials need to be conducted to clarify the effectiveness of ω-3 polyunsaturated fatty acids.

No MeSH data available.


Related in: MedlinePlus