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Nutrients 2014, 6(6), 2148-2164; doi:10.3390/nu6062148

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

1,2,* , 1,2,3,4,* , 2,5
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Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Beijing 100730, China
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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
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Department of Trauma Surgery, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences, Chengdu 610101, China
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Department of Clinical Nutrition, Xin Hua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China
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Department of Biochemistry, Luzhou Medical College, Luzhou 646000, China
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Authors to whom correspondence should be addressed.
Received: 5 March 2014 / Revised: 29 April 2014 / Accepted: 16 May 2014 / Published: 30 May 2014
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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. View Full-Text
Keywords: omega-3 fatty acids; severe illness; parenteral nutrition; enteral nutrition; meta-analysis omega-3 fatty acids; severe illness; parenteral nutrition; enteral nutrition; meta-analysis
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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MDPI and ACS Style

Chen, W.; Jiang, H.; Zhou, Z.-Y.; Tao, Y.-X.; Cai, B.; Liu, J.; Yang, H.; Lu, C.D.; Zeng, J. Is Omega-3 Fatty Acids Enriched Nutrition Support Safe for Critical Ill Patients? A Systematic Review and Meta-Analysis. Nutrients 2014, 6, 2148-2164.

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