Importance of n-3 polyunsaturated fatty acids in critical care

Abstract

N-3 polyunsaturated fatty acids (PUFAs) include alpha-linolenic acid, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), among others. Alpha-linolenic acid is found in flaxseed oil. EPA and DHA are found in blueback fish oil. It has been suggested that n-3 PUFAs have nutritional benefits including suppression of inflammation and decreased total mortality. Therefore, we pose the question: are n-3 PUFAs effective in the treatment of critical care patients? The following beneficial effects of n-3 PUFAs in critical care have been suggested: reduced postoperative atrial fibrillation (AF), protection against ischemia-reperfusion injury, prevention of some cancers, and decreased risk of developing sepsis. The underlying mechanisms might relate to the effect of n-3 PUFAs on immune system regulation. The importance of n-3 PUFAs has been suggested by guidelines issued by the European Society for Clinical Nutrition and Metabolism (ESPEN). For example, diets containing n-3 PUFAs, often described as immunonutrition, aim at enhancing the immune function in surgical patients. However, there is limited evidence describing the criteria for the use of n-3 PUFAs in critical care; therefore, additional research is needed.