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Cited by 38Clinical Nutrition and GastroenterologyFatty Acid Research and HealthHyperglycemia and glycemic control in critically ill and hospitalized patients

Is Omega-3 Fatty Acids Enriched Nutrition Support Safe for Critical Ill Patients? A Systematic Review and Meta-Analysis

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Chen, Wei, Jiang, Hua, Zhou, Zhi-Yuan, Tao, Ye-Xuan, Cai, Bin, Liu, Jie, Yang, Hao, Lu, Charles +1 more·2014·Nutrients
DOI 10.3390/nu6062148PMC PMC4073140
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Abstract

Objective: To systematically review the effects of omega-3 poly unsaturated fatty acids (FA) enriched nutrition support on the mortality of critically illness patients. Methods: Databases of Medline, ISI, Cochrane Library, and Chinese Biomedicine Database were searched and randomized controlled trials (RCTs) were identified. We enrolled RCTs that compared fish oil enriched nutrition support and standard nutrition support. Major outcome is mortality. Methodological quality assessment was conducted based on Modified Jadad’s score scale. For control heterogeneity, we developed a method that integrated I2 test, nutritional support route subgroup analysis and clinical condition of severity. RevMan 5.0 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used for meta-analysis. Results: Twelve trials involving 1208 patients that met all the inclusion criteria. Heterogeneity existed between the trials. A random model was used, there was no significant effect on mortality RR, 0.82, 95% confidence interval (CI) (0.62, 1.09), p = 0.18. Knowing that the route of fish oil administration may affect heterogeneity, we categorized the trials into two sub-groups: parenteral administration (PN) of omega-3 and enteral administration (EN) of omega-3. Six trials administered omega-3 FA through PN. Pooled results indicated that omega-3 FA had no significant effect on mortality, RR 0.76, 95% CI (0.52, 1.10), p = 0.15. Six trials used omega-3 fatty acids enriched EN. After excluded one trial that was identified as source of heterogeneity, pooled data indicated omega-3 FA enriched EN significant reduce mortality, RR=0.69, 95% CI [0.53, 0.91] (p = 0.007). Conclusion: Omega-3 FA enriched nutrition support is safe. Due to the limited sample size of the included trials, further large-scale RCTs are needed.

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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 [264]

    The Study Selection section describes randomized trials of omega-3-enriched nutrition in critically ill ICU patients, supporting the claim that such comparisons were studied. But the Results (section 3.2) analyze mortality, not morbidity in surgical ICU patients: they report no significant overall mortality effect or effect in the parenteral subgroup. The paper therefore does not establish the claimed reduction in morbidity compared with other lipid emulsions. (LLM, conf=0.80)

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Cited by

Sorted by citations

Authors
Chen, W., Jiang, H., Zhou, Z.-Y., Tao, Y.-X., Cai, B., Liu, J., Yang, H., Lu, C., & Zeng, J.
Affiliations
  • Peking Union Medical College Hospital (CN)
  • Shanghai Jiao Tong University (CN)
  • Southwest Medical University (CN)
  • Department of Computational Mathematics and Bio-statistics, Metabolomics and Multidisciplinary Laboratory for Trauma Research, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences, Chengdu 610101, China
  • Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (CN)
Corresponding author
  • Chen, Wei
  • Jiang, Hua
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2014-05-30
Volume
6
Issue
6
Pages
2148-2164
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu6062148
PMC
PMC4073140
OpenAlex
W1990811757
Cited by
38
References
4
Citations by year
2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 4 · 2019: 3 · 2018: 4 · 2017: 4 · 2016: 3 · 2015: 4 · 2014: 2 · 2013: 1
FWCI
0.50
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • University of Waikato
  • Academy of Medical Sciences
  • School of Medicine, Vanderbilt University
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
omega-3 fatty acids, fish oil, nutritional support, critically ill patients, mortality, parenteral nutrition, enteral nutrition, route of administration, safety
MeSH terms
Humans, Fatty Acids, Omega-3, Critical Illness, Nutritional Support

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