Effect of enterally administered n-3 polyunsaturated fatty acids in acute pancreatitis—a prospective randomized clinical trial

Background: In acute pancreatitis (AP) administration of n-3 polyunsaturated fatty acids (PUFAs) might change the course of the disease through modulation of eicosanoid synthesis. Patients and Methods: In a prospective, randomized clinical trial from 28 patients with moderate-severe AP, 14 received n-3 PUFAs (fish oil) enterally (3.3 g/day for 5–7 days). Measurement of erythrocyte superoxide-dysmutase (SOD) activity, serum total antioxidant status (TAS), vitamin A and E, fatty acids, C-reactive protein, transthyretin concentrations were performed at admission, day 3, 7 and 14. Results: The n-3 to n-6 LCPUFA ratios increased significantly in serum lipids of the patients receiving n-3 PUFA supplementation, whereas remained unchanged in the controls. Supplementation resulted in significant decrease in length of hospitalization (13.07±6.70 vs. 19.28±7.18 days, P<0.05) and jejunal feeding (10.57±6.70 vs. 17.57±10.52, P<0.05). Complications developed in 6/14 (42%) of treated and 9/14 (64%) of control patients. The SOD activity was significantly higher at day 3 in the supplemented group (P<0.05), but there were no significant differences between the two groups in other antioxidants and acute phase reactants. Conclusion: The use of enteral formula enriched with n-3 PUFAs in the treatment of AP seems to have clinical benefits based upon the shortened time of jejunal feeding and hospital stay.