Background and Importance The purpose of this study was to compare the changes in the clinical values of fish oil and non-oil-based TPN in critically ill patients and to provide a clinical rationale for TPN administration.

Aim and Objectives Data were collected from critically ill patients who received TNA (Fish oil-based or non- Fish oil-based TNA, the latter consisting of olive-soybean oil-based TNA or soybean oil-based TNA) at Veterans Health Service medical centre from 1 June 2019 to 31 May 2021.

Material and Methods Albumin, hs CRP, AST, ALT, Total Bilirubin (TB), PT.INR, WBC, Hb, Hct, PLT, Lymphocyte( LYT) levels were analysed.

Results This study collected 224 subjects (172 fish oil-based TNA, 45 olive soybean oil-based TNA, and 7 soybean oil-based TNA). The mean changes in hs-CRP before and after TNA injection were -8.71, -47.48, and -33.33 in the order of fish oil, olive-soybean oil, and soybean oil. The albumin level changes were -0.26, +0.05, and -0.03, respectively. Other than that, there were no statistically significant changes.

In the olive-soybean oil group, the decrease in hs-CRP showed a tendency to increase as the number of prescription days increased. Only in the fish oil group, as the APACHE2 score increased, the TB (p<0.01) and AST (p<0.01) tended to increase, and the thrombocytopenia tended to increase (p<0.01). In the olive soybean oil group (p<0.01) and soybean oil group (p=0.037), the increase in INR tended to increase as the BMI increased. In the fish oil group, ALT increased with age (p=0.014).

Conclusion and Relevance As a result of the study, there was no significant difference in clinical values between the preparations containing fish oil and the preparations containing non-fish oil except for hs-CRP and albumin. Therefore, it is judged that considering the nutritional components and economic feasibility of TNA preparations when administering TNA will be helpful in improving the nutritional status of patients and reducing the economic burden.

Conflict of Interest No conflict of interest