Outcomes with perioperative fat emulsions containing omega-3 fatty acid: A meta-analysis of randomized controlled trials

Bae, Hye Jung; Lee, Gwan Young; Seong, Jong-Mi; Gwak, Hye Sun

doi:10.2146/ajhp151015

Cited by 24 publications

(57 citation statements)

References 42 publications

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“…A meta‐analysis of postoperative patients with colorectal cancer also showed that patients receiving FO‐containing PN had lower levels of TNF‐α ( P = .01) and IL‐6 ( P = .02) . Similarly, a large meta‐analyses of 19 RCTs of perioperative patients (n = 1167) by Bae et al found that patients who received FO‐containing PN had a reduction in TNF‐α, whereas those without FO in their PN did not ( P = .0009). In addition, Liang et al found patients who received a 5:1 ratio of LCT:FO had lower IL‐6 levels by POD 8 ( P = .039) and higher CD4 + /CD8 + levels ( P = .035) than the control group who received 100% LCTs from SO.…”

Section: Literature Reviewmentioning

confidence: 91%

“…Surgical critical care patients experience high levels of inflammation . Studies reviewed found that patients who received FO ILE had lower proinflammatory markers . A double‐blind RCT of 78 patients with severe sepsis and acute gastrointestinal injury grade III found lower cluster of differentiation 3 (CD3) T lymphocytes (mean difference −8.21; 95% CI: −15.11 to −1.31) and lower helper T lymphocytes (mean difference −6.22; 95% CI: −12.02 to −0.42) in patients receiving a blend of 10 g of FO and 50 g of SO in PN when compared with patients receiving 50 g of SO alone in their PN .…”

Section: Literature Reviewmentioning

confidence: 99%

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Impact of Intravenous Lipid Emulsions Containing Fish Oil on Clinical Outcomes in Critically Ill Surgical Patients: A Literature Review

2018

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A fish oil (FO)–containing intravenous lipid emulsion (ILE; FO ILE) has been approved for use in the United States; however, similar formulations have been used throughout Europe and China in intensive care units since the 1990s. This literature review evaluates the evidence regarding the effectiveness of FO ILE on clinical outcomes in the critically ill surgical patient population. The review of available evidence demonstrates that ILEs containing FO lower triglyceride concentrations, inflammatory markers, and liver function enzymes, and improve morbidity and mortality outcomes in critically ill surgical patients.

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Section: Literature Reviewmentioning

confidence: 91%

Section: Literature Reviewmentioning

confidence: 99%

Impact of Intravenous Lipid Emulsions Containing Fish Oil on Clinical Outcomes in Critically Ill Surgical Patients: A Literature Review

2018

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“…Evidence from clinical studies and meta‐analyses demonstrates that lipid emulsions containing fish oil offer several clinical advantages compared with those containing no fish oil in adult surgical patients, including reduced risk of infectious complications, decreased length of stay in the ICU, and decreased length of stay in the hospital . According to the European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines on clinical nutrition in surgery, postoperative PN including ω‐3 fatty acids should be considered only in patients who cannot be adequately fed enterally and thus require PN (grade of recommendation B: majority agreement [65%]) …”

Section: Hospitalized Adults Requiring Pnmentioning

confidence: 99%

Summary of Proceedings and Expert Consensus Statements From the International Summit “Lipids in Parenteral Nutrition”

Martindale

Berlana

Boullata

et al. 2020

J Parenter Enteral Nutr

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Background The 2018 Lipids in Parenteral Nutrition summit involved a panel of experts in clinical nutrition, lipid metabolism, and pharmacology, to assess the current state of knowledge and develop expert consensus statements regarding the use of intravenous lipid emulsions in various patient populations and clinical settings. The main purpose of the consensus statements is to assist healthcare professionals by providing practical guidance on common clinical questions related to the provision of lipid emulsions as part of parenteral nutrition (PN). Methods The summit was designed to allow interactive discussion and consensus development. The resulting consensus statements represent the collective opinion of the members of the expert panel, which was informed and supported by scientific evidence and clinical experience. Results The current article summarizes the key discussion topics from the summit and provides a set of consensus statements designed to complement existing evidence‐based guidelines. Lipid emulsions are a major component of PN, serving as a condensed source of energy and essential fatty acids. In addition, lipids modulate a variety of biologic functions, including inflammatory and immune responses, coagulation, and cell signaling. A growing body of evidence suggests that lipid emulsions containing ω‐3 fatty acids from fish oil confer important clinical benefits via suppression of inflammatory mediators and activation of pathways involved in the resolution of inflammation. Conclusions This article provides a set of expert consensus statements to complement formal PN guideline recommendations.

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“…In this section the clinical data from systematic reviews and meta‐analyses will be considered regarding the use of parenteral nutrition enriched with ω‐3 fatty acids in a range of hospitalized patients, including surgical patients. Since 2010, at least 11 meta‐analyses have been published concerning parenteral nutrition with and without ω‐3 fatty acids (Table ) . These meta‐analyses have covered surgical patients, a mixture of ICU and non‐ICU (surgical) patients, and ICU and/or critically ill patients .…”

Section: Surgical Patientsmentioning

confidence: 99%

“…The meta‐analyses show the following clinical benefits for parenteral nutrition with ω‐3 fatty acids rather than standard lipid emulsions: infectious complications were significantly reduced in non‐ICU/surgical patients, ICU patients, and a mixed population of ICU and non‐ICU (surgical) patients significantly shorter hospital length of stay significantly shorter ICU length of stay …”

Section: Surgical Patientsmentioning

confidence: 99%

Lipid Use in Hospitalized Adults Requiring Parenteral Nutrition

Mayer

Kłęk²,

Garcı́a-de-Lorenzo

et al. 2020

J Parenter Enteral Nutr

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In hospitalized patients, lipid emulsions are an integral part of balanced parenteral nutrition. Traditionally, a single lipid source, soybean oil, has been given to patients and was usually regarded as just a source of energy and to prevent essential fatty‐acid deficiency. However, mixtures of different lipid emulsions have now become widely available, including mixtures of soybean oil, medium‐chain triglycerides, olive oil, and fish oil. Fish oil is high in the ω‐3 polyunsaturated fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). There is a growing body of evidence that these ω‐3 fatty acids can exert beneficial immunomodulatory, anti‐inflammatory, and inflammation‐resolution effects across a wide range of patient groups including surgical, cancer, and critically ill patients. At least in part, these effects are realized via potent specialized pro‐resolution mediators (SPMs). Moreover, parenteral nutrition including ω‐3 fatty acids can result in additional clinical benefits over the use of standard lipid emulsions, such as reductions in infection rates and length of hospital and intensive care unit stay. Clinical and experimental evidence is reviewed regarding lipid emulsion use in a variety of hospitalized patient groups, including surgical, critically ill, sepsis, trauma, and acute pancreatitis patients. Practical aspects of lipid emulsion use in critically ill patients are also considered, such as how to determine and fulfill energy expenditure, how and when to consider parenteral nutrition, duration of infusion, and safety monitoring.

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Outcomes with perioperative fat emulsions containing omega-3 fatty acid: A meta-analysis of randomized controlled trials

Abstract: The results of the meta-analysis indicated that FO-containing IVFEs could improve infectious morbidity and LOS. The overall effect of reducing infectious morbidity and LOS was found to be the greatest in comparison with the SO-based IVFEs.

Cited by 24 publications

References 42 publications

Impact of Intravenous Lipid Emulsions Containing Fish Oil on Clinical Outcomes in Critically Ill Surgical Patients: A Literature Review

Impact of Intravenous Lipid Emulsions Containing Fish Oil on Clinical Outcomes in Critically Ill Surgical Patients: A Literature Review

Summary of Proceedings and Expert Consensus Statements From the International Summit “Lipids in Parenteral Nutrition”

Lipid Use in Hospitalized Adults Requiring Parenteral Nutrition

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