Fish Oil–Containing Lipid Emulsions in Adult Parenteral Nutrition: A Review of the Evidence
Open accessAbstract
Background . There is evidence from laboratory and animal studies that fish oil–containing intravenous lipid emulsions (FOC‐IVLEs) have a beneficial effect on inflammation and the immune response, suggesting a possible clinical benefit. Clinical studies of FOC‐IVLEs have reported mixed results. The aim of this review is to present findings from recent randomized controlled clinical trials and other quality clinical studies investigating the effects of administering intravenous fish oil alone or as part of a multilipid emulsion and to examine the quality of these studies in an objective, evidence‐based manner. Methods . Studies comparing FOC‐IVLEs with other IVLEs in adults were included. Thirty‐four clinical studies were evaluated: 19 investigated levels of inflammatory and immune markers as an endpoint; 13 investigated rates of infection or sepsis; 3 investigated clinical outcomes in septic patients; and 29 investigated general clinical outcomes. Results . There was conflicting evidence for a beneficial effect of fish oil on levels of inflammatory and immune markers and some evidence that fish oil decreased the rate of postoperative atrial fibrillation. Studies generally reported few statistical differences in clinical outcomes and rates of infection and sepsis with FOC‐IVLEs as compared with other IVLEs. The quality of reporting was generally poor, and the presented evidence for comparisons between FOC‐IVLEs and other IVLEs was inconclusive or weak. Conclusions . There is very little high‐quality evidence that FOC‐IVLEs have a more beneficial effect than other IVLEs on clinical outcomes in adult patients.
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Prospective randomized studies including surgical patients admitted in the ICU have shown less morbidity in the fish oil group compared to other lipid emulsions.
“Prospective randomized studies including surgical patients admitted in the ICU for a period of their hospitalization have shown less morbidity in the fish oil group compared to other lipid emulsions(259, 260, 261, 262, 263, 264).”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [259]
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- Authors
- Abbasoglu, O., Hardy, G., Manzanares, W., & Pontes‐Arruda, A.
- Affiliations
- Massey University (NZ)
- Universidad de la República de Uruguay (UY)
- Baxter (United States) (US)
- Corresponding author
- Pontes‐Arruda, Alessandro
- Venue
- Journal of Parenteral and Enteral Nutrition
- Publisher
- Wiley
- Published
- 2017-12-19
- Volume
- 43
- Issue
- 4
- Pages
- 458-470
- ISSN
- 0148-6071 (ISSN-L)
- 1941-2444
- OpenAlex
- W2743314936
- Cited by
- 30
- References
- 52
- Citations by year
- 2026: 1 · 2024: 5 · 2023: 3 · 2022: 4 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 8 · 2017: 1
- FWCI
- 0.42
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Parenteral and Enteral Nutrition (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
- Keywords
- fish oil, intravenous lipid emulsion, parenteral nutrition, anti-inflammatory activity, immune response, sepsis, infection, postoperative atrial fibrillation, quality of evidence, randomized controlled trials
- MeSH terms
- Adult, Fat Emulsions, Intravenous, Fish Oils, Humans, Immunity, Inflammation, Parenteral Nutrition, Randomized Controlled Trials as Topic, Treatment Outcome, Evidence-Based Medicine
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