{"id":"758144e5-b3d4-42f1-9f1d-bd9a41265e68","slug":"long-chain-omega-3-fatty-acids-in-aneurysmal-subarachnoid-hemorrhage-a-randomized-pilot-trial-of-pharmaconutrition","title":"Long-chain omega-3 fatty acids in aneurysmal subarachnoid hemorrhage: A randomized pilot trial of pharmaconutrition","authors":["Geisi Saito","Rodrigo Zapata","Rodrigo Rivera","Héctor Zambrano","David Rojas","Hernán Acevedo","Franco Ravera","John Mosquera","Juan E. Vásquez","Jorge Mura"],"abstract":"Background: Functional recovery after aneurysmal subarachnoid hemorrhage (SAH) remains a significant problem. We tested a novel therapeutic approach with long-chain omega-3 polyunsaturated fatty acids (n-3 PUFAs) to assess the safety and feasibility of an effectiveness trial. Methods: We conducted a multicentre, parallel, randomized, open-label pilot trial. Patients admitted within 72 hours after SAH with modified Fisher scale scores of 3 or 4 who were selected for scheduled aneurysm clipping were allocated to receive either n-3 PUFA treatment (parenteral perioperative: 5 days; oral: 8 weeks) plus usual care or usual care alone. Exploratory outcome measures included major postoperative intracranial bleeding complications (PIBCs), cerebral infarction caused by delayed cerebral ischemia, shunt-dependent hydrocephalus, and consent rate. The computed tomography evaluator was blinded to the group assignment. Results: Forty-one patients were randomized, but one patient had to be excluded after allocation. Twenty patients remained for intention to treat analysis in each trial arm. No PIBs (95% confidence interval [CI]: 0.00 to 0.16) or other unexpected harm were observed in the intervention group (IG). No patient suspended the intervention due to side effects. There was a trend towards improvements in all benefit-related outcomes in the IG. The overall consent rate was 0.91 (95% CI: 0.78 to 0.96), and there was no consent withdrawal. Conclusions: Although the balance between the benefit and harm of the intervention appears highly favourable, further testing on SAH patients is required. We recommend proceeding with amendments in a dose-finding trial to determine the optimal duration of parenteral treatment.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/758144e5-b3d4-42f1-9f1d-bd9a41265e68/featured/hero-1782420886252.png","publishDate":"2017-12-27T00:00:00.000Z","doi":"10.4103/sni.sni_266_17","categories":["Neurovascular","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/758144e5-b3d4-42f1-9f1d-bd9a41265e68/pdf"}