Intravenous fish oil lipid emulsions in critically ill patients: an updated systematic review and meta-analysis
Manzanares W, Langlois PL, Dhaliwal R, Lemieux M, Heyland DK
Critical care (London, England) · 80 citas
Etiquetas de revisión
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Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2015-04-02 · Crit Care · vol. 19 · número 1 · pág. 167
- Editorial
- BioMed Central
- Citado
- 114 citas · más que el 93% de estudios similares · 2.9× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 75 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Clinical Nutrition and Gastroenterology · Fatty Acid Research and Health · Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Palabras clave
- 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
- humans, critical illness, fat emulsions, intravenous, fish oils, parenteral nutrition, length of stay, intensive care units
5 autores
- William Manzanares🇺🇾 · autor de correspondenciaUniversidad de la República de Uruguay
- Pascal L. Langlois🇨🇦Université de Sherbrooke; Centre Hospitalier Universitaire de Sherbrooke; Hôpital Fleurimont
- Rupinder Dhaliwal🇨🇦Kingston General Hospital; Clinical Evaluation Research Unit
- Margot Lemieux🇨🇦Kingston General Hospital; Clinical Evaluation Research Unit
- Daren Keith Heyland🇨🇦Queen's University; Kingston General Hospital; Clinical Evaluation Research Unit
Resumen
El texto original del estudio, en el idioma en que se publicó.
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 I (2) = 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 I (2) =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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