Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Anaesthesia and Pain Relief

Malnutrition in cancer patients who are candidates for major surgery is considered a problem because it represents a risk factor for postoperative morbidity and mortality. Administration of standard parenteral diets supplemented with omega-3 (} - 3) fatty acids (immunonutrition) modulates immune and inflammatory responses and gut function in elective surgical patients, immunonutrition is associated with a reduction in infectious complication rates and a shorter length of hospital stay. The present study included 40 patients divided to two groups, group A: including 20 patients receiving the traditional intralipid emulsion, and group B: including 20patients receiving the new omega 3 SMO Flipid 20% lipid emulsion. The subjective global assessment method of nutrition (class B and C) is used as screening test to select patients in the study which takes into consideration body weight, dietary intake, GIT symptoms. In all patients parenteral nutrition support was started at day 1 to provide 25 - 30 kcal/kg/d and 1 - 1.5 g protein/kg/d, at least for 7 days post operative. 30 - 40% of non protein caloric intake was provided from lipid emulsions. All patients received perioperative fluids, electrolytes, trace elements, micronutrients, prophylactic antibiotics, and deep venous thrombosis and stress ulcer prophylaxis as clinically prescribed. Parameters measured in the study were leukotriens B5 (LTB5) as anti - inflammatory mediator which were quantified using ELISA technique. Other parameter measured were weights, serum Na, K, Ca, Mg and kidney functions - urea and creatinine

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