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Cited by 116Clinical Nutrition and GastroenterologyFatty Acid Research and HealthHyperglycemia and glycemic control in critically ill and hospitalized patients

Intravenous fish oil lipid emulsions in critically ill patients: an updated systematic review and meta-analysis

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Manzanares, William, Langlois, Pascal L, Dhaliwal, Rupinder, Lemieux, Margot, Heyland, Daren K·2015·Critical Care
DOI 10.1186/s13054-015-0888-7PMC PMC4404291
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Abstract

Introduction: Intravenous fish oil (FO) lipid emulsions (LEs) are rich in ω-3 polyunsaturated fatty acids, which exhibit anti-inflammatory and immunomodulatory effects. We previously demonstrated that FO-containing LEs may be able to decrease mortality and ventilation days in patients who are critically ill. Since 2014, several additional randomized controlled trials (RCTs) of FO-containing LEs have been published. Therefore, the purpose of this systematic review was to update our previous systematic review with the aim of elucidating the efficacy of FO-containing LEs on clinical outcomes of patients who are critically ill. Methods: We searched electronic databases from 1980 to 2014. We included four new RCTs conducted in critically ill adult patients in which researchers evaluated FO-containing LEs in parenterally or enterally fed patients. Results: A total of 10 RCTs (n = 733) met inclusion criteria. The mean methodological score was 8 (range, 3 to 12). No effect on overall mortality was found. When we aggregated the results of five RCTs in which infections were reported, we found that FO-containing LEs significantly reduced infections (risk ratio (RR) = 0.64; 95% confidence interval (CI), 0.44 to 0.92; P = 0.02; heterogeneity I2 = 0%). Subgroup analysis demonstrated that predominantly enteral nutrition–based trials showed a tendency toward a reduction in mortality (RR = 0.69; 95% CI, 0.40 to 1.18; P =0.18; heterogeneity I2 =35%). High-quality trials showed a significant reduction in hospital length of stay (LOS) (weighted mean difference = −7.42; 95% CI, −11.89 to −2.94; P = 0.001), whereas low-quality trials had no effect (P = 0.45). The results of the test for subgroup differences in hospital LOS was significant (P = 0.001). Conclusion: FO-containing LEs may be associated with a reduction in infections and also could be associated with a reduction in duration of ventilation and hospital LOS. Further large-scale RCTs are warranted and should be aimed at consolidating potential positive treatment effects.

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  • Manzanares et al. and Zhu et al. also showed a decrease in infections.

    “Those of Palmer et al. (267), Chen et al. (268), Pradelli et al. (269), Manzanares et al. (270) and Zhu et al. (271) showed a decrease in length of stay, while Manzanares et al. (270) and Zhu et al. (271) also showed a decrease in infections.”

    From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [271]

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Authors
Manzanares, W., Langlois, P. L., Dhaliwal, R., Lemieux, M., & Heyland, D. K.
Affiliations
  • Universidad de la República de Uruguay (UY)
  • Université de Sherbrooke (CA)
  • Kingston General Hospital (CA)
  • Queen's University (CA)
Corresponding author
Manzanares, William
ORCID
Venue
Critical Care
Publisher
Springer Science and Business Media LLC
Published
2015-12
Volume
19
Issue
1
Pages
167-167
ISSN
1364-8535 (ISSN-L)
DOI
10.1186/s13054-015-0888-7
PMC
PMC4404291
OpenAlex
W1995529636
Cited by
116
References
1
Citations by year
2026: 6 · 2025: 4 · 2024: 2 · 2023: 6 · 2022: 6 · 2021: 7 · 2020: 15 · 2019: 13 · 2018: 15 · 2017: 24 · 2016: 14 · 2015: 4
FWCI
2.44
Type
journal article
Language
en
Open access
Licence
Locations
  • Critical Care (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • 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 › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
Keywords
fish oil lipid emulsion, omega-3 polyunsaturated fatty acids, critically ill patients, parenteral nutrition, enteral nutrition, infection reduction, mortality, mechanical ventilation duration, length of hospital stay, anti-inflammatory activity
MeSH terms
Fat Emulsions, Intravenous, Fish Oils, Humans, Intensive Care Units, Length of Stay, Parenteral Nutrition, Critical Illness

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