Early enteral feeding in postsurgical cancer patients: Fish oil structured lipid-based polymeric formula versus a standard polymeric formula

Andrew S. Kenler, Wendy S. Swails, David F. Driscoll, Stephen J. DeMichele, Brian Daley, Timothy J. Babineau, Myron B. Peterson, Bruce R. Bistrian

Research output: Contribution to journalArticle

142 Citations (Scopus)

Abstract

Objectives: The authors compared the safety, gastrointestinal tolerance, and clinical efficacy of feeding an enteral diet containing a fish oil/medium-chain triglyceride structured lipid (FOSL-HN) versus an isonitrogenous, isocaloric formula (O-HN) in patients undergoing major abdominal surgery for upper gastrointestinal malignancies. Summary Background Data: Previous studies suggest that feeding with n-3 fatty acids from fish oil can alter eicosanoid and cytokine production, yielding an improved immunocompetence and a reduced inflammatory response to injury. The use of n- 3 fatty acids as a structured lipid can improve long-chain fatty acid absorption. Methods: This prospective, blinded, randomized trial was conducted in 50 adult patients who were jejunally fed either FOSL-HN or O-HN for 7 days. Serum chemistries, hematology, urinalysis, gastrointestinal complications, liver and renal function, plasma and erythrocyte fatty acid analysis, urinary prostaglandins, and outcome parameters were measured at baseline and on day 7. Comparisons were made in 18 and 17 evaluable patients based a priori on the ability to reach a tube feeding rate of 40 mL/hour. Results: Patients receiving FOSL-HN experienced no untoward side effects, significant incorporation of eicosapentaenoic acid into plasma and erythrocyte phospholipids, and a 50% decline in the total number of gastrointestinal complications and infections compared with patients given O- HN. The data strongly suggest improved liver and renal function during the postoperative period in the FOSL-HN group. Conclusion: Early enteral feeding with FOSL-HN was safe and well tolerated. Results suggest that the use of such a formula during the postoperative period may reduce the number of infectious and gastrointesinal complications per patient, as well as improve renal and liver function through modulation of urinary prostaglandin levels. Additional clinical trials to fully quantify clinical benefits and optimize nutritional support with FOSL-HN should be undertaken.

Original languageEnglish (US)
Pages (from-to)316-333
Number of pages18
JournalAnnals of surgery
Volume223
Issue number3
DOIs
StatePublished - Mar 28 1996

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Fish Oils
Enteral Nutrition
Lipids
Neoplasms
Omega-3 Fatty Acids
Kidney
Postoperative Period
Prostaglandins
Liver
Fatty Acids
Erythrocytes
Immunocompetence
Urinalysis
Eicosapentaenoic Acid
Nutritional Support
Eicosanoids
Hematology
Phospholipids
Triglycerides
Clinical Trials

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Early enteral feeding in postsurgical cancer patients : Fish oil structured lipid-based polymeric formula versus a standard polymeric formula. / Kenler, Andrew S.; Swails, Wendy S.; Driscoll, David F.; DeMichele, Stephen J.; Daley, Brian; Babineau, Timothy J.; Peterson, Myron B.; Bistrian, Bruce R.

In: Annals of surgery, Vol. 223, No. 3, 28.03.1996, p. 316-333.

Research output: Contribution to journalArticle

Kenler, Andrew S. ; Swails, Wendy S. ; Driscoll, David F. ; DeMichele, Stephen J. ; Daley, Brian ; Babineau, Timothy J. ; Peterson, Myron B. ; Bistrian, Bruce R. / Early enteral feeding in postsurgical cancer patients : Fish oil structured lipid-based polymeric formula versus a standard polymeric formula. In: Annals of surgery. 1996 ; Vol. 223, No. 3. pp. 316-333.
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AU - DeMichele, Stephen J.

AU - Daley, Brian

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AU - Peterson, Myron B.

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