Effects of fish oil-containing nutrition supplementation in adult sepsis patients: a systematic review and meta-analysis

BACKGROUND: Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Although fish oil has been used as an immunonutritional preparations for the treatment of sepsis patients, there is still controversy as to whether it is beneficial to them. We systematically reviewed published clinical trial data to evaluate the effectiveness of fish oil-containing nutrition supplementation in sepsis patients. METHODS: A systematic search was undertaken in PubMed, Embase, Chinese Biomedicine Database, the Cochrane Library and the China Knowledge Resource Integrated Database to obtain clinical controlled trails. RCTs on nutrition therapy containing fish oil among adult sepsis patients were selected for analysis in comparison with routine therapy. RESULTS: Twenty-five published trials were included in the meta-analysis. Fish oil-containing nutrition supplementation reduced the mortality compared with the control group (relative risk (RR) 0.74, I(2) = 0%). Fish oil also shortened the ICU stay (MD −3.57 days; 95% CI −4.54, −2.59; p<0.00001; I(2) = 76%), hospital stay (MD −9.92 days; 95% CI −15.37, −4.46; p = 0.0004; I(2) = 91%) and the duration of mechanical ventilation support (MD −2.26; 95% CI −4.27, −0.26; p = 0.03; I(2) = 83%). A subgroup analysis based on the route of administration revealed that parenteral administration of fish oil could reduce mortality in septic patients (RR =0.68, I(2) = 0%), but no significant difference in mortality was observed in the fish oil group administered by enteral route (RR = 0.80, I(2) = 0%). No statistically significant publication biases were detected for the above clinical endpoints (p>0.05). CONCLUSIONS: Parenteral nutrition containing fish oil could significantly decrease mortality in sepsis patients while enteral administration could not. Fish oil-containing nutrition supplementation.