BackgroundNutritional supplementation of omega-3 fatty acids has been proposed to modulate the balance of pro- and anti-inflammatory mediators in sepsis. If proved to improve clinical outcomes in critically ill patients with sepsis, this intervention would be easy to implement. However, the cumulative evidence from several randomized clinical trials (RCTs) remains unclear.MethodsWe searched the Cochrane Library, MEDLINE, and EMBASE through December 2016 for RCTs on parenteral or enteral omega-3 supplementation in adult critically ill patients diagnosed with sepsis or septic shock. We analysed the included studies for mortality, intensive care unit (ICU) length of stay, and duration of mechanical ventilation, and used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the quality of the evidence for each outcome.ResultsA total of 17 RCTs enrolling 1239 patients met our inclusion criteria. Omega-3 supplementation compared to no supplementation or placebo had no significant effect on mortality [relative risk (RR) 0.85; 95% confidence interval (CI) 0.71, 1.03; P = 0.10; I 2 = 0%; moderate quality], but significantly reduced ICU length of stay [mean difference (MD) −3.79 days; 95% CI −5.49, −2.09; P < 0.0001, I 2 = 82%; very low quality] and duration of mechanical ventilation (MD −2.27 days; 95% CI −4.27, −0.27; P = 0.03, I 2 = 60%; very low quality). However, sensitivity analyses challenged the robustness of these results.ConclusionOmega-3 nutritional supplementation may reduce ICU length of stay and duration of mechanical ventilation without significantly affecting mortality, but the very low quality of overall evidence is insufficient to justify the routine use of omega-3 fatty acids in the management of sepsis.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-017-0282-5) contains supplementary material, which is available to authorized users.

Race, ethnicity, and ancestry are common classification variables used in health research. However, there has been no formal agreement on the definitions of these terms, resulting in misuse, confusion, and a lack of clarity surrounding these concepts for researchers and their readers. This article examines past and current understandings of race, ethnicity, and ancestry in research, identifies the distinctions between these terms, examines the reliability of these terms, and provides researchers with guidance on how to use these terms. Although race, ethnicity, and ancestry are often treated synonymously, they should be considered as distinct terms in the context of health research. Researchers should carefully consider which term is most appropriate for their study, define and use the terms consistently, and consider how their classification may be used in future research by others. The classification should be self-reported rather than assigned by an observer wherever possible.

Public health data have demonstrated disproportionate COVID-19 morbidity and mortality among racialized populations. However, limited hospital data may prevent research into racial disproportionality among inpatients. We conducted a retrospective cross-sectional study of patients admitted with or without COVID-19 to an Ontario tertiary hospital between March and October 2020 to determine the percentage of inpatients with a formal race or ethnicity assessment in their medical record. The COVID-19 group included inpatients with concurrent COVID-19 positivity; the reference group included a random sample of General Medicine inpatients without COVID-19. We reviewed 80 patients with COVID-19 and 80 patients without COVID-19. Formal ethnicity assessments were recorded among 44% of the COVID-19 group and 49% of the reference group. Race and ethnicity data collection was less than 50% among inpatients with and without COVID-19 in one Ontario hospital. Adequate data collection is necessary to study racial health disparities in the hospital setting.

Race, ethnicity, and ancestry are common classification variables used in health research. However, there has been no formal agreement on the definitions of these terms, resulting in misuse, confusion, and a lack of clarity surrounding these concepts for researchers and their readers. This article examines past and current understandings of race, ethnicity, and ancestry in research, identifies the distinctions between these terms, examines the reliability of race, ethnicity, and ancestry classification, and provides researchers with guidance on how to use these terms. Although race, ethnicity, and ancestry are often treated synonymously, they should be considered as distinct terms in the context of health research. Researchers should carefully consider which term is most appropriate for their study, define and use the terms consistently, and consider how their classification may be used in future research by others. The classification should be self-reported rather than assigned by an observer wherever possible.

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