Fish Oil-Containing Emulsions: When Fat Seems to Improve Clinical Outcomes in the Critically Ill.

Third generation lipid emulsions were developed as a soybean oil sparing strategy with the aim to provide ω-3 polyunsaturated fatty acids (ω-3-PUFAs) derived from fish oil (FO), such as eicosapentanoic acid (EPA) and decosahexanoic acid (DHA), and reduce the amount of ω-6 polyunsaturated fatty acids (ω-6-PUFAs), which have been associated with negative effects on immune function and inflammatory response [1,2]. Over the last decade, several relatively small phase II randomized controlled trials (RCTs) have evaluated clinical and mechanistic effects of intravenous (I.V.) FO containing emulsions in intensive care unit (ICU) patients.