The influence on blood clotting of the consumption of fish oils.

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There is strong evidence that the use of omega-3 fatty acids (O3FAs) reduces cardiovascular risk in certain populations. Major bodies such as the Australian National Heart Foundation (NHF), American Heart Association (AHA) and British Heart Foundation (BHF) have recommended their use which has lead to widespread uptake by the general population. As their use becomes more prevalent, increasing numbers of patients are presenting for surgery whilst taking O3FAs. Amongst the potential adverse effects of O3FAs, there is theoretical suspicion that these compounds may reduce blood coagulability. Both the AHA and BHF have issued cautionary statements regarding this. This is of clinical interest as it could increase both perioperative blood loss, and the risk of serious complications with certain anaesthetic techniques. Previous studies investigating this effect have used older laboratory measures of coagulation which show little correlation with clinical bleeding risk. In the absence of good evidence disproving their theoretical suspicions, many surgeons and anaesthetists may advise patients to discontinue fish oils for several days prior to surgery. Given that the perioperative period is a time of increased cardiovascular risk, this decision is not without risk to the patient. We plan to investigate the effects of two different doses of fish oils on blood coagulation as measured by several laboratory tests which have been shown to have a much stronger correlation with clinical bleeding risk than traditional tests used in earlier studies.

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