Yanping Mo1, Xiaolan Hu, Lili Chang, Penglin Ma. 1. The PLA Medical College, Beijing 100853, China. Corresponding author: Ma Penglin, Department of Intensive Care Unit, 309th Hospital, Beijing 100091, China, Email: mapenglin1@163.com.
Abstract
OBJECTIVE: To determine whether the supplementation of ω-3 polyunsaturated fatty acids in parenteral nutrition (PN) confers treatment benefits to outcomes of septic patients. METHODS: The databases of MEDLINE, EMBASE, Cochrane central register of controlled trials, the CNKI and the Wanfang biomedicine were searched to identify prospective randomized controlled trials (RCTs) which compared the ω-3 polyunsaturated fatty acids supplemented with the standard PN on outcomes of adult patients with sepsis from January 1996 to June 2013. The methodological quality of the included studies was evaluated, and the Cochrane Collaboration RevMan 5.0 was used for data analysis. RESULTS: A total of 12 studies enrolling 721 patients were included. Significant reduction in 28-day mortality [relative risk (RR) 0.77, 95% confidence interval (95%CI) 0.59 to 0.99, P=0.04], short intensive care unit [ICU, weighted mean difference (WMD)=-3.10, 95%CI -5.98 to -0.21, P=0.04] and hospital length of stay (WMD=-3.12, 95%CI -4.65 to -1.60, P<0.000 1) were observed in patients receiving ω-3 polyunsaturated fatty acids supplemented PN. There was no differences in days of mechanical ventilation between patients with or without adding ω-3 polyunsaturated fatty acids in PN (WMD=1.33, 95%CI -5.09 to 7.75, P=0.69). CONCLUSIONS: Meta-analysis results demonstrated that PN supplemented with ω-3 polyunsaturated fatty acids was beneficial in improving the outcomes of patients with sepsis. However, this conclusion must be interpreted with caution due to the low quality of the enrolled trials.
OBJECTIVE: To determine whether the supplementation of ω-3 polyunsaturated fatty acids in parenteral nutrition (PN) confers treatment benefits to outcomes of septic patients. METHODS: The databases of MEDLINE, EMBASE, Cochrane central register of controlled trials, the CNKI and the Wanfang biomedicine were searched to identify prospective randomized controlled trials (RCTs) which compared the ω-3 polyunsaturated fatty acids supplemented with the standard PN on outcomes of adult patients with sepsis from January 1996 to June 2013. The methodological quality of the included studies was evaluated, and the Cochrane Collaboration RevMan 5.0 was used for data analysis. RESULTS: A total of 12 studies enrolling 721 patients were included. Significant reduction in 28-day mortality [relative risk (RR) 0.77, 95% confidence interval (95%CI) 0.59 to 0.99, P=0.04], short intensive care unit [ICU, weighted mean difference (WMD)=-3.10, 95%CI -5.98 to -0.21, P=0.04] and hospital length of stay (WMD=-3.12, 95%CI -4.65 to -1.60, P<0.000 1) were observed in patients receiving ω-3 polyunsaturated fatty acids supplemented PN. There was no differences in days of mechanical ventilation between patients with or without adding ω-3 polyunsaturated fatty acids in PN (WMD=1.33, 95%CI -5.09 to 7.75, P=0.69). CONCLUSIONS: Meta-analysis results demonstrated that PN supplemented with ω-3 polyunsaturated fatty acids was beneficial in improving the outcomes of patients with sepsis. However, this conclusion must be interpreted with caution due to the low quality of the enrolled trials.
Authors: Clara Lu; Sunjay Sharma; Lauralyn McIntyre; Andrew Rhodes; Laura Evans; Saleh Almenawer; Lori Leduc; Derek C Angus; Waleed Alhazzani Journal: Ann Intensive Care Date: 2017-06-05 Impact factor: 6.925