Intravenous Fish Oil Based Lipid Emulsion to Enhance Recovery in High-Risk Cardiac Surgery Patients

Exclusion Criteria

• •1. Known hypersensitivity to fish oil/fish products or egg protein
• •2. Pregnancy or lactation period
• •3. Previous history of chronic atrial fibrillation, atrial flutter and/or atrial tachyarrhythmia
• •4. Inability or unwillingness of individual to give written informed consent
• •5. Not expected to survive an additional 48 hours from screening evaluation
• •6. Lack of commitment to full, aggressive care (anticipated withholding or withdrawing treatments in the first week but isolated "Do not Resuscitate" \[DNR\] acceptable)
• •7. Patients admitted with diabetic ketoacidosis or non-ketotic hyperosmolar coma
• •8. Patients receiving extracorporeal mechanical assist device (e.g. ECLS, or IABP) or advanced heart failure therapies (e.g. TAH, VAD)
• •9. Enrolment in anyinterventional trial within the last 30 days
• •10. Already receiving FO-containing medical nutrition products
• •11. Severe malnutrition (as defined by the BMI \<18.5)
• •12. Severe liver dysfunction defined by Child Pugh Class C.
• •13. Severe chronic kidney dysfunction defined by the National Kidney Foundation (NKF) stage 4 and 5 by using the glomerular filtration rate (GFR \<30ml/min)
• •14. Known severe coagulation disorder