A large body of evidence has accumulated showing that n-3 PUFAs exert extensive cardiac effects. The development of commercial solutions of FO opens perspectives for therapeutic applications in patients with acute cardiac conditions.the 3 following hypotheses will be addressed in patients requiring cardiac surgery under cardiopulmonary bypass or after myocardial infarction:perioperative /post-PTCA intravenous fish oil modifies the composition of membrane phospholipids in platelets and cardiac cells, blunts the physiological response to cardiac surgery/myocardial infarction, and reduces the incidence of arrhythmias, and reduces the occurrence of systolic dysfunction.
A. Randomized trial in 40 cardiac surgery patients Early rapid infusion of fish oil (3 times in 24 hours) in cardiac surgery patients. B. Randomized trial 20 myocardial infarction patients (abandonned) Continuous infusion of the same dose over 24hrs in the myocardial infarction patients Additional trial in healthy volunteers (investigating physiological changes after cardiac study): -Open trial in 8 healthy lean volunteers to investigate the impact of the same 0.6 g/kg FO dose IV (Week 1: 3hrs), and then orally on week 2, on platelet n-3 PUFA incorporation, platelet function, heart rate and peak flow response to stress test.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
31
0.2 g/kg FO, 3 times in 24 hours, infused over 3 hours each in cardiac surgery, or continuous infusion of 0.6 g/kg post PTCA
3 infusions, perioperative or post-PTCA
CHUV
Lausanne, Canton of Vaud, Switzerland
Service of Adult Intensive Care - CHUV
Lausanne, Canton of Vaud, Switzerland
Incorporation of n-3 PUFA into platelet cell membrane and myocardial tissue
The primary outcome is the determination of magnitude of the incorporation and the time required for incorporation of omega-3 fatty acid cell membrane composition after short intravenous infusions was unknown until the present study (HPLC determination of fatty acid membrane composition in all patients)
Time frame: 48 hours
Inflammatory and metabolic response
cytokine determination, CRP, glucose control (blood levels and insulin requirements) in all patients
Time frame: From operation to ICU discharge (maximum 28 days)
Global clinical outcome
length of mechanical ventilation, length of ICU and hospital stay in all patients
Time frame: From operation to hospital discharge (maximum 28 days)
Myocardial recovery after surgery
Holter monitoring during cardiac surgery or for 72 hours
Time frame: From operation to hospital discharge (maximum 28 days)
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