Comparative effects of olive oil-based and soyabean oil-based emulsions on infection rate and leucocyte count in critically ill patients receiving parenteral nutrition

Br J Nutr. 2008 Apr;99(4):846-54. doi: 10.1017/S0007114507837433. Epub 2007 Oct 5.

Abstract

Soyabean oil-based emulsions high in linoleic acid used in parenteral nutrition (PN) could interfere with immune function and may increase the risk of septic complications. Olive oil-based emulsions, high in oleic acid, could have fewer immune effects. We compared the effects of a soyabean oil-based emulsion v. an olive oil-based emulsion on infection rate, appearance of new infection episodes, leucocyte count (peak and evolution), acute-phase proteins, and major health outcomes in intensive care unit (ICU) adult patients receiving PN. The study was designed as an observational, retrospective, single-centre, cohort study in a general ICU. Patients in the SOYA cohort (n 16) received a soyabean oil-based emulsion and patients in the OLIVE cohort (n 23), an olive oil-based emulsion. Both cohorts had similar basal characteristics and received a similar energy load. The SOYA cohort received an oleic acid:linoleic acid ratio of 0.43 and the OLIVE cohort 2.99 (P < 0.001). No differences were observed in infection rate and appearance, acute-phase proteins, and major health outcomes. At the end of PN, blood leucocyte count decreased by 3.25 x 109 cells/l in the SOYA cohort and increased by 4.51 x 109 cells/l in the OLIVE cohort from baseline values (P = 0.036). Peak leucocyte count presented a trend for a higher value in the OLIVE cohort v. the SOYA cohort (18.86 v. 15.28 x 109 cells/l; P = 0.078). The use of an olive oil-based emulsion in PN had no effect on infection, acute-phase proteins, major health outcomes, and presented higher leucocyte count at the end of PN and a trend to higher peak leucocyte count when compared with soyabean oil-based emulsion in ICU patients.

Publication types

  • Comparative Study

MeSH terms

  • Acute-Phase Proteins / analysis
  • Critical Care / methods*
  • Fat Emulsions, Intravenous / therapeutic use*
  • Female
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Leukocyte Count
  • Linoleic Acid / administration & dosage
  • Male
  • Middle Aged
  • Oleic Acid / administration & dosage
  • Olive Oil
  • Parenteral Nutrition, Total / methods*
  • Plant Oils*
  • Retrospective Studies
  • Sepsis / diet therapy
  • Sepsis / immunology*
  • Sepsis / microbiology
  • Soybean Oil*

Substances

  • Acute-Phase Proteins
  • Fat Emulsions, Intravenous
  • Olive Oil
  • Plant Oils
  • Oleic Acid
  • Soybean Oil
  • Linoleic Acid