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January 11, 2012

Supplementation in Acute Lung Injury

Author Affiliations

Author Affiliation: Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts (bbistria@bidmc.harvard.edu).

JAMA. 2012;307(2):144-146. doi:10.1001/jama.2011.1983

To the Editor: The finding that bolus feeding of a supplement containing n-3 fatty acids, GLA, and antioxidants to patients with ALI did not improve outcomes is important.1 However, this study also suggests that intermittent administration of pharmacologic quantities of n-3 fatty acids to patients with limited nutritional intake does not quickly alter membrane phospholipid fatty acid composition. The authors measured the fatty acid profile of the total plasma lipids (in eMethods of the article), which reflects membrane phospholipid composition, but their findings of increases in eicosapentaenoic acid (EPA) and docosahexaenoic acid, but not decreases in arachidonic acid, in plasma suggest that membrane phospholipid composition had not changed fully. When provided with adequate feeding for a sufficient time period, fish oil reduces arachidonic acid levels by displacement with EPA2-4 and is a major contributing factor to anti-inflammatory action.5