Current evidence on ω-3 fatty acids in enteral nutrition in the critically ill: A systematic review and meta-analysis

Koekkoek, Wac Kristine; Panteleon, Vasilianna; Zanten, Arthur R. H. van

doi:10.1016/j.nut.2018.07.013

Cited by 41 publications

(24 citation statements)

References 67 publications

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“…However, 28-day mortality, ICU length of stay, and ventilation duration were significantly decreased in the subgroup of patients with ARDS. No significant effects on infectious complications were observed in overall or subgroup analyses [67].…”

Section: Omega-3 Fatty Acidsmentioning

confidence: 79%

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Nutrition in Sepsis: A Bench-to-Bedside Review

2020

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Nutrition therapy in sepsis is challenging and differs from the standard feeding approach in critically ill patients. The dysregulated host response caused by infection induces progressive physiologic alterations, which may limit metabolic capacity by impairing mitochondrial function. Hence, early artificial nutrition should be ramped-up and emphasis laid on the post-acute phase of critical illness. Caloric dosing is ideally guided by indirect calorimetry, and endogenous energy production should be considered. Proteins should initially be delivered at low volume and progressively increased to 1.3 g/kg/day following shock symptoms wane. Both the enteral and parenteral route can be (simultaneously) used to cover caloric and protein targets. Regarding pharmaconutrition, a low dose glutamine seems appropriate in patients receiving parenteral nutrition. Supplementing arginine or selenium is not recommended. High-dose vitamin C administration may offer substantial benefit, but actual evidence is too limited for advocating its routine use in sepsis. Omega-3 polyunsaturated fatty acids to modulate metabolic processes can be safely used, but non-inferiority to other intravenous lipid emulsions remains unproven in septic patients. Nutrition stewardship, defined as the whole of interventions to optimize nutritional approach and treatment, should be pursued in all septic patients but may be difficult to accomplish within a context of profoundly altered cellular metabolic processes and organ dysfunction caused by time-bound excessive inflammation and/or immune suppression. This review aims to provide an overview and practical recommendations of all aspects of nutritional therapy in the setting of sepsis.

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Section: Omega-3 Fatty Acidsmentioning

confidence: 79%

“…Koekkoek et al [67] reviewed 24 RCTs enrolling 3574 medical, surgical, and trauma patients that addressed relevant clinical outcomes of fish oil-containing EN in critically ill patients. Enteral fish oil supplementation reduced ICU length of stay and ventilation duration but did not affect 28-day, ICU or hospital mortality.…”

Section: Omega-3 Fatty Acidsmentioning

confidence: 99%

Nutrition in Sepsis: A Bench-to-Bedside Review

2020

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“…In recent years, omega-3 fatty acids have attracted much attention due to their ability to reduce inflammation and regulate immunity. It has been reported [ 12 , 13 ] that it can inhibit inflammation and regulate immunity in many diseases. It has good effects in the treatment of severe patients such as sepsis and systemic inflammatory response syndrome [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

The effects and safety of omega-3 fatty for acute lung injury: a systematic review and meta-analysis

Huang¹,

Zheng²,

Huang³

et al. 2020

World J Surg Onc

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Background: Several randomized controlled trials (RCTs) have compared the treatment of acute lung injury (ALI) with omega-3 fatty, yet the results remained inconsistent. Therefore, we attempted this meta-analysis to analyze the role of omega-3 fatty in the treatment of ALI patients. Methods: We searched PubMed databases from inception date to October 31, 2019, for RCTs that compared the treatment of ALI with or without omega-3 fatty. Two authors independently screened the studies and extracted data from the published articles. Summary mean differences (MD) with 95% confidence intervals (CI) were calculated for each outcome by fixed-or random-effects model. Results: Six RCTs with a total of 277 patients were identified, of whom 142 patients with omega-3 fatty acid treatment and 135 patients without omega-3 fatty treatment. Omega-3 fatty treatments significantly improve the PaO 2 (MD = 13.82, 95% CI 8.55-19.09), PaO 2 /FiO 2 (MD = 33.47, 95% CI 24.22-42.72), total protein (MD = 2.02, 95% CI 0.43-3.62) in ALI patients, and omega-3 fatty acid treatments reduced the duration of mechanical ventilation (MD = − 1.72, 95% CI − 2.84 to − 0.60) and intensive care unit stay (MD = − 1.29, 95% CI − 2.14 to − 0.43) in ALI patients. Conclusions: Omega-3 fatty can effectively improve the respiratory function and promote the recovery of ALI patients. Future studies focused on the long-term efficacy and safety of omega-3 fatty use for ALI are needed.

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“…Due to differences in selection criteria and outcome measures, the outcomes are varied. In 2018, Koekkoek et al ( 262 ) reviewed 24 RCTs of fish-oil–containing EN involving 3574 patients. There was no significant benefit on the primary outcome of 28-d, ICU, or hospital mortality.…”

Section: Resultsmentioning

confidence: 99%

The Role of Nutrition in COVID-19 Susceptibility and Severity of Disease: A Systematic Review

James

Ali

Armitage

et al. 2021

The Journal of Nutrition

105

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Background Many nutrients have powerful immunomodulatory actions with the potential to alter susceptibility to coronavirus disease 2019 (COVID-19) infection, progression to symptoms, likelihood of severe disease, and survival. Objective The aim was to review the latest evidence on how malnutrition across all its forms (under- and overnutrition and micronutrient status) may influence both susceptibility to, and progression of, COVID-19. Methods We synthesized information on 13 nutrition-related components and their potential interactions with COVID-19: overweight, obesity, and diabetes; protein-energy malnutrition; anemia; vitamins A, C, D, and E; PUFAs; iron; selenium; zinc; antioxidants; and nutritional support. For each section we provide: 1) a landscape review of pertinent material; 2) a systematic search of the literature in PubMed and EMBASE databases, including a wide range of preprint servers; and 3) a screen of 6 clinical trial registries. All original research was considered, without restriction to study design, and included if it covered: 1) severe acute respiratory syndrome coronavirus (CoV) 2 (SARS-CoV-2), Middle East respiratory syndrome CoV (MERS-CoV), or SARS-CoV viruses and 2) disease susceptibility or 3) disease progression, and 4) the nutritional component of interest. Searches took place between 16 May and 11 August 2020. Results Across the 13 searches, 2732 articles from PubMed and EMBASE, 4164 articles from the preprint servers, and 433 trials were returned. In the final narrative synthesis, we include 22 published articles, 38 preprint articles, and 79 trials. Conclusions Currently there is limited evidence that high-dose supplements of micronutrients will either prevent severe disease or speed up recovery. However, results of clinical trials are eagerly awaited. Given the known impacts of all forms of malnutrition on the immune system, public health strategies to reduce micronutrient deficiencies and undernutrition remain of critical importance. Furthermore, there is strong evidence that prevention of obesity and type 2 diabetes will reduce the risk of serious COVID-19 outcomes. This review is registered at PROSPERO as CRD42020186194.

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Current evidence on ω-3 fatty acids in enteral nutrition in the critically ill: A systematic review and meta-analysis

Cited by 41 publications

References 67 publications

Nutrition in Sepsis: A Bench-to-Bedside Review

Nutrition in Sepsis: A Bench-to-Bedside Review

The effects and safety of omega-3 fatty for acute lung injury: a systematic review and meta-analysis

The Role of Nutrition in COVID-19 Susceptibility and Severity of Disease: A Systematic Review

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