Effects of fish oil-containing nutrition supplementation in adult sepsis patients: a systematic review and meta-analysis

Abstract

Background Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Although fish oil has been used as an immunonutritional preparations for the treatment of sepsis patients, there is still controversy as to whether it is beneficial to them. We systematically reviewed published clinical trial data to evaluate the effectiveness of fish oil-containing nutrition supplementation in sepsis patients. Methods A systematic search was undertaken in PubMed, Embase, Chinese Biomedicine Database, the Cochrane Library and the China Knowledge Resource Integrated Database to obtain clinical controlled trails. RCTs on nutrition therapy containing fish oil among adult sepsis patients were selected for analysis in comparison with routine therapy. Results Twenty-five published trials were included in the meta-analysis. Fish oil-containing nutrition supplementation reduced the mortality compared with the control group (relative risk (RR) 0.74, I2 = 0%). Fish oil also shortened the ICU stay (MD −3.57 days; 95% CI −4.54, −2.59; p<0.00001; I2 = 76%), hospital stay (MD −9.92 days; 95% CI −15.37, −4.46; p = 0.0004; I2 = 91%) and the duration of mechanical ventilation support (MD −2.26; 95% CI −4.27, −0.26; p = 0.03; I2 = 83%). A subgroup analysis based on the route of administration revealed that parenteral administration of fish oil could reduce mortality in septic patients (RR =0.68, I2 = 0%), but no significant difference in mortality was observed in the fish oil group administered by enteral route (RR = 0.80, I2 = 0%). No statistically significant publication biases were detected for the above clinical endpoints (p>0.05). Conclusions Parenteral nutrition containing fish oil could significantly decrease mortality in sepsis patients while enteral administration could not. Fish oil-containing nutrition supplementation.

Metabolic Reprogramming and Its Regulatory Mechanism in Sepsis-Mediated Inflammation

“…99 A systematic review showed that parenteral nutrition containing fish oil, which is full of Ω-3 lipid, could significantly decrease mortality in sepsis patients. 100 In addition, Due to both energetic and metabolic consequences, mitochondrial dysfunction appears to play a significant role in the pathogenesis of sepsis. 101 This makes them a valuable subject for further research and a potential target for future therapies.…”

The role of omega-3 polyunsaturated fatty acids in the intensive care unit

“…Hereunder we review the data that might support this hypothesis. A number of meta-analyses of relevant trials of omega-3 PUFAs have been published recently [34 ▪ ,35 ▪ ,36,37]. Pradelli et al [34 ▪ ] reviewed 49 randomized controlled trials (RCTs) comparing omega-3 PUFA enriched PN with standard (nonomega-3 PUFA enriched) PN in adult hospitalized patients.…”

“…Omega-3 PUFAs were associated with lower mortality (RR 0.82, 95% CI 0.69, 0.97), shorter duration of mechanical ventilation (weight mean difference −2.20 days, 95% CI −4.00, −0.40), and shorter ICU LOS (weight mean difference −3.86 days, 95% CI −5.72, −2.01). Most recently, Wang et al [37] analyzed findings of 25 RCTs of enteral or parenteral provision of omega-3 PUFAs to patients with sepsis. They found that omega-3 PUFAs reduced mortality (RR 0.74, 95% CI 0.63, 0.86), and shortened duration of mechanical ventilation (weight mean difference −2.26 days, 95% CI −4.27, −0.26), ICU LOS (weight mean difference −3.57 days, 95% CI −4.54, −2.59) and hospital LOS (weight mean difference −9.92 days, 95% CI −15.37, −4.46).…”

The Role of Immunonutrition in Patients

“…Their potential role in elective surgery has been well documented: the benefits have also been supported by several very recent systematic reviews and meta-analyses, revealing a reduced risk of complications, lower length of hospital stays, and reduced mortality [ 3 , 4 , 5 ]. IN has shown its efficacy also in improving clinical outcomes in acute pancreatitis [ 6 ], critical illness [ 7 ], acute respiratory distress syndrome [ 8 ], and sepsis [ 9 ].…”