Omegaven

Omegaven as supplement in PN is indicated:

Parenteral nutrition supplementation with long chain omega-3-fatty acids, especially eicosapentaenoic and docosahexaenoic acid, when oral or enteral nutrition is impossible, insufficient or contraindicated.

Adults:

• 1 ml up to max. 2 ml Omegaven/kg body weight
• The infusion rate should not exceed 0.5 ml Omegaven/kg body weight/hour be administered simultaneously with other fat emulsions
• Recommended total daily lipid intake of 1 - 2 g/kg body weight, the fish oil portion from Omegaven should constitute 10 - 20% of this intake

• ​Presentation :

Glass bottles 50ml,100ml

• Dosage / Administration:

Please refer to the nationally registered and approved product information

• Especially following patient groups can benefit most from Omegaven:
  • Post-traumatic & post surgical
  • With different stages of abdominal & non-abdominal sepsis/SIRS
  • With peritonitis
  • Whose immune function is in need of support
  • At risk of any chronic or acute hyper-inflammatory process

 

• Omega 3 PUFA-enriched lipid emulsions are associated with a statistically and clinically significant reduction in infection rate and length of ICU and hospital stay

Antebi H, Mansoor O, Ferrier C, Tetegan M, Morvan C, Rangaraj J, Alcindor LG. Anti-oxidant potential, alpha-tocopherol and retinol plasma levels in stressed patients on TPN: effect of Lipoven and SMOF. Abstract 65, ESPEN 2000, Clin Nutr 2000; 19(suppl 2):16

Ayala et al. Dietary n-3 polyunsaturated fatty acid modulation of immune cell function before or after trauma. Nutrition 1995; 11: 1-11.

Babcock et al. Eicosapentaenoic acid (EPA): an anti-inflammatory -3 fat with potential clinical applications. Nutrition 2000;16: 1116-1118.

De Vizia B, Raia V, Spano C, Pavlidis C, Coruzzo A, Alessio M. Effect of an 8-month treatment with omega-3 fatty acids (eicosapentaenoic and docosahexaenoic) in patients with cystic fibrosis. J Parenter Enteral Nutr. 2003;27(1):52-7

Fearon KCH. The anticancer and anticachectic effects of n-3 fatty acids. Clin Nutr 2002; 21 Suppl 2: 73-77

Foitzik T, Eibl G, Schneider P, Wenger FA, Jacobi CA, Buhr HJ. Omega-3 fatty acid supplementation increases anti-inflammatory cytokines and attenuates systemic disease sequelae in experimental pancreatitis. JPEN J Parenter Enteral Nutr. 2002 Nov-Dec;26(6):351-6.

Gadek JE, DeMichele SJ, Karlstad MD, Pacht ER, Donahoe M, Albertson TE, Van Hoozen C, Wennberg AK, Nelson JL, Noursalehi M. Effect of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. Enteral Nutrition in ARDS Study Group. Crit Care Med 1999 Aug;27(8):1409-20

Garcia-Garmendia et al. Cytokine levels in critically-ill septic patients fed with an enteral diet supplemented with fish oil and vitamin E. Clin. Nutr. 1998; 17: 6 (ESPEN Abstract Band).

Grecu I, Mirea L, Grintescu I. Parenteral fish oil supplementation in patients with abdominal sepsis. Clin Nutr 2003;22:Suppl.1

Grimble R. Use of n-3 fatty acid-containing lipid emulsions in the intensive care unit environment: the scientist´s view. Clin Nutr 2002; 21 Suppl 2: 15-20

Grimm et al. Immunsuppressivitat parenteraler Fettemulsionen bei definierter Immunstimulation, (Immunosuppressive character of parenteral fat emulsions in a defined immune stimulation) Infusionsther. Transfusionsmed. 1995; 22: 110-116.

Grimm H, Kraus A. Immunonutrition--supplementary amino acids and fatty acids ameliorate immune deficiency in critically ill patients. Langenbecks Arch Surg 2001 Aug;386(5):369-76

Grimm H, Mayer K, Mayser P, Eigenbrodt E. Regulatory potential of n-3 fatty acids in immunologically and inflammatory processes. Brit J Nutr 2002;87, Suppl.1:S59-S67

Grimminger F, Seeger W, Mayer K. Use of n-3 fatty acid-containing lipid emulsions in the intensive care unit environment: the clinician´s view. Clin Nutr 2002; 21 Suppl 2: 23-9

Hailer S, Matthias M, Wolf S,  Jauch KW, Wolfram G. Influence of fish oil containing emulsions on plasma lipids and blood cell membranes in patients after major abdominal surgery. Clin Nutr 2001; 20 Suppl. 3: 40-1

Heller A, Koch T, Schmeck J, van Ackern K. Lipid mediators in inflammatory disorders. Drugs 1998: Apr: 55 (4):487-96

Heller A, Koch T. Omega-3-Fettsäuren als adjuvante Therapie bei inflammatorischen Reaktionen. Anästhesiol Intensivmed 1996; 10 (37): 517-28

Heller AR, Fischer S, Roessel T, Gottschlich B, Ragaller M, Tiebel O, Menschikowski M, Zimmermann T, Albrecht DM, Koch T. Immunonutritional aspects of parenteral fish oil supplementaton after major abdominal surgery. Crit Care Med 2001, 29(12): A127 (Abstract)

Heller AR, Fischer S, Rössel T, Geiger S, Siegert G, Ragaller M, Zimmermann T, Koch T. Impact of n-3 fatty acid supplemented parenteral nutrition on haemostasis pattern after major abdominal surgery. Brit J Nutr 2002 (87) Suppl1: S95-S101

Heller AR, Rössel T, Gottschlich B, Tiebel O, Menschikowski M, Litz RJ, Zimmermann T, Koch T. Omega-3 fatty acids improve liver and pancreas function in postoperative cancer patients. Int J Cancer 2004:111, 611-616

Heller AR, Striebel J, Koch T. Effects of fish-oil supplementation on the clinical course of critical illness. A multicenter trial. Eur J Anaesthesiol Suppl. 2003;20. (Abstract)

Jordan A, Stein J. Effect of an omega-3 fatty acid containing lipid emulsion alone and in combination with 5-fluorouracil (%-FU) on growth of the colon cancer cell line Caco-2. Eur J Nutr 2003;42:324-31

Kelbel I, Koch T, Prechtl A, Heller A, Schlotzer E, Schiefer G, Neuhof H. Effects of Parenteral Application of Fish Oil versus Soy Oil Emulsions on Bacterial Clearance Functions. Infusionsther Transfusionsmed 1999; 26:226-32

Kelbel IU, Wagner F, Wiedeck-Suger, Kelbel M, Weiss M, Schneider M, Grünert A, Hatrung T, Georgieff M. Effects of n-3 fatty acids on immune function: a double blind, randomized trial of fish oil based infusion in post-operative patients. Clin Nutr 2002;21Suppl 1:13

Koch T, Heller A, Breil I, van Ackern K, Neuhof H. Alterations of pulmonary capillary filtration and leukotriene synthesis due to infusion of a lipid emulsion enriched with Omega-3 fatty acids. Clin Intens Care 1995; 6:112-20

Koch T; Duncker HP, Klein A, Schlotzer E, Peskar BM, van Ackern K, Neuhof H. Modulation of pulmonary vascular resistance and oedema formation by short-term infusion of a 10% fish oil emulsion. Infusions Ther Transfus Medizin 1993; 20: 291-300

Köller M, Senkal M, Kemen M, König W, Muhr G. Leukotriene synthesis of leukocytes from patients with major surgery after postoperative parenteral nutrition enriched with omega-3-fatty acids. Clin Nutr 2001; 20 suppl.1: 7

Lanza-Jacoby S, Flynn JT, Miller S. Parenteral supplementation with a fish oil emulsion prolongs survival and improves lymphocyte function in sepsis. Nutrition 2001; 17: 112-6

Lee S, Desai S, Babcock T, Helton WS, Espat NJ. Omega -3 fatty acids induce pancreatic cancer cell cycle arrest in vitro in a dose- and time-dependent manner. Abstract 2003, AHPBA

Matthies et al. Influence of total parenteral nutrition enriched with -3-fatty acids on cytokine levels in patients with major surgery. Shock 2000;13: 167 (Abstract).

Mayer K, Fegbeutel C, Hattar K, Sibelius U, Krämer HJ, Heuer KU, Temmesfed-Wollbrück B, Gokorsch S, Grimminger F, Seeger W. w-3 and w-6 lipid emulsions exert differential influence on neutrophils in septic shock patients: impact on plasma fatty acids and lipid mediator generation. Int Care Med 2003;29:1472-81

Mayer K, Gokorsch S, Fegbeutel C, Hattar K, Rosseau S, Walmrath D, Seeger W, Grimminger F. Parenteral nutrition with fish oil modulates cytokine response in patietns with sepsis. Am J Respir Crit Care Med 2003;167:1321-8

Mayer K, Grimm H, Grimminger F, Seeger W. Parenteral nutrition with n3 lipids in sepsis. Brit J Nutr 2002; 87, Suppl 1 S69-S75

Mayser P, Grimm H, Grimminger F: n-3 Fatty acids in psoriasis. Brit J Nutr 2002; 87 Suppl 1: S77-S82

Mayser P, Mayer K, Mahloudjian M, Benzing S, Kramer HJ, Schill WB, Seeger W, Grimminger F. A double-blind, randomized, placebo-controlled trial of n-3 versus n-6 fatty acid-based lipid infusion in atopic dermatitis. J Parenter Enteral Nutr 2002;26(3):151-8

Morlion BJ, Torwesten E, Lessire H, Sturm G, Peskar BM, Fürst P, Puchstein C. The effect of parenteral fish oil on leukocyte membrane fatty acid composition and leukotriene synthesizing capacity in postoperative trauma. Metabolism 1996; 45: 1208-13

Morlion BJ, Torwesten E, Wrenger K, Puchstein C, Fürst P. What is the optimum w-3 to w-6 fatty acid ratio of parenteral fatty acid ratio of parenteral lipid emulsions in postoperative care? (abstract P.98) Clin Nutr 16(Suppl 2):49; 1997

Roulet M, Frascarolo P, Pilet M, Chapuis G. Effects of intravenously infused fish oil on platelet fatty acid phospholipid composition and on platelet function in postoperative trauma. J Parenteral and Enteral Nutr 1997; 21:296-301

Schulzki C, Mertes N, Wenn A, et al. Effect of a new type of lipid emulsion based on soybean oil, MCT, olive oil and fish oil (SMOF) in surgical patients. ESPEN abstract no 27. Clin Nutr 1999, 18(suppl.1):7

Suchner U, Katz DP, Furst P, Beck K, Felbinger TW, Senftleben U, Thiel M, Goetz, AE, Peter K. Effects of intravenous fat emulsions on lung function in patients with acute respiratory distress syndrome or sepsis. Crit Care Med 2001 Aug;29(8):1569-74

Suchner U, Katz P, Furst P, Beck K, Felbinger W, Thiel M, Senftleben U, Goetz E, Peter K. Impact of sepsis, lung injury, and the role of lipid infusion on circulating prostacyclin and thromboxane A(2). Intensive Care Med 2002 Feb;28(2):122-9

Tappy L, Berger MM, Schwarz JM, Revelly JP, Cayeux MC, Bollmann M, Chiolero R. Metabolic effects of parenteral nutrition with or without N-3 fatty acids. Clin Nutr. 2003 Aug;22(S1):S50.

Thies F, Miles EA, Nebe-von-Caron G, Powell JR, Hurst TL, Newsholme EA, Calder PC. Influence of dietary supplementation with long-chain n-3 or n-6 polyunsaturated fatty acids on blood inflammatory cell populations and functions and on plasma soluble adhesion molecules in healthy adults. Lipids 2001 Nov;36(11):1183-93.

Tsekos E, Reuter C, Stehle P, Boeden G. Perioperative administration of parenteral fish oil supplements in a routine clinical setting improves patient outcome after major abdominal surgery. Clin Nutr 2004;23.325-30

Weiss G, Meyer F, Matthies B, Pross M, Koenig W, Lippert H. Immunomodulation by perioperative administration of n-3 fatty acids. Br J Nutr 2002 Jan;87 Suppl 1:S89-94

Highly refined fishoil:                                     10.0 g

Containing

eicosapentaenoic acid (EPA)                           1.25 - 2.82 g

docosahexaenoic acid (DHA)                           1.44 - 3.09 g

dl-alpha-Tocopherol                                       0.015 – 0.0296 g                                                                                 

Purified egg phospholipids                               1.2 g                                                                                                  

Glycerol                                                         2.5 g                                                                                                  

pH value                                                        7.5 to 8.7                                                                                            

Osmolality                                                     308 – 376 (mosm/kg)

Osmolarity                                                     273 (mosmol/ l)                                                                                        

Energy (kcal/l)    470 kJ/100ml = 112 kcal/100ml

As Omegaven is a supplement, please see some examples regarding compatability:

• Omegaven (0 – 100 ml) & Kabiven central (1026 ml, 1540 ml, 2053 ml, 2566 ml):  

stable for 48 hours between 20°C - 25°C (not stable for 7 days (6+1) when containing Omegaven)

• Omegaven (10 – 150 ml) & Single lipid emulsions (e.g. Intralipid, Lipovenoes 10% PLR, Lipovenoes MCT):
  • Stable for 24 hours at 20°C-25°C.
  • 7 days, i.e. 6 days storage at 2-8°C followed by 24 hours at 20°C-25°C.