ω-3 Fatty-Acid Enriched Parenteral Nutrition in Hospitalized Patients: Systematic Review With Meta-Analysis and Trial Sequential Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 31250474 · doi:10.1002/jpen.1672
What was done
A systematic review and meta-analysis with trial sequential analysis (PROSPERO CRD42018110179) compared omega-3 fatty-acid enriched parenteral nutrition (PN) against standard non-omega-3 lipid emulsions in adult hospitalized patients. The analysis included 49 randomized controlled trials (RCTs) where PN provided at least 70% of energy needs. Primary outcomes included infection and mortality.
What was found
Omega-3 enriched PN reduced infection risk by 40% (24 RCTs; RR 0.60, 95% CI 0.49-0.72; P < 0.00001) and sepsis risk by 56% (9 RCTs; RR 0.44, 95% CI 0.28-0.70; P = 0.0004). Mean intensive care unit stay was reduced by 1.95 days (10 RCTs; 95% CI 0.42-3.49; P = 0.01) and total hospital stay by 2.14 days (26 RCTs; 95% CI 1.36-2.93; P < 0.00001). Mortality rate showed a non-statistically significant 16% reduction (20 RCTs; RR 0.84, 95% CI 0.65-1.07; P = 0.15).
Why it matters
This meta-analysis provides strong evidence supporting the preferential use of omega-3 lipid emulsions over standard emulsions in hospitalized patients requiring parenteral nutrition to lower infectious complications and shorten hospitalization.
Limits
The total participant sample size across the 49 trials is not stated in the abstract. Specific omega-3 doses, emulsion compositions, patient sub-populations, safety endpoints, and trial sequential analysis stopping boundaries are not detailed in the abstract text.
Cited by
- partial A meta-analysis found that parenteral omega-3 supplementation in hospitalized patients reduces ICU length of stay and decreases mortality by up to 60%.