Omega-3 fatty-acid enriched parenteral nutrition improves patient outcomes
A new systematic literature review and meta-analysis1 confirms and extends previous results that omega-3 (omega-3) fatty-acid enriched parenteral nutrition (PN) improves clinical outcomes compared with standard PN in adult patients. Including a total of 49 randomized controlled trials (RCTs), this literature review provides the most extensive and up-to-date analysis* of the effect of omega-3 fatty-acid enriched PN on patient outcomes.
According to this analysis, adding omega-3 fatty acids to PN significantly reduces the risk of infections by 40 % and the length of ICU and hospital stays by two days compared with standard PN. Moreover, the analysis revealed that PN enriched with fish oil significantly reduces sepsis by 56 %. An analysis of RCTs reporting laboratory parameters furthermore suggests that omega-3 fatty-acid enriched PN can have beneficial effects on liver chemistry, antioxidant status, markers of inflammation, and the fatty-acid profile. The authors conclude that lipid emulsions enriched with omega-3 fatty acids should be preferred over standard lipid emulsions in patients needing PN.
About the review and meta-analysis
The meta-analysis by Lorenzo Pradelli and colleagues was published in the Journal of Parenteral and Enteral Nutrition in June 2019. The review includes a total of 49 RCTs with 3641 adult hospital patients comparing outcomes between groups receiving omega-3 fatty-acid enriched lipid emulsions and groups receiving standard lipid emulsions as part of PN. Only those RCTs were included, in which PN accounted for at least 70 % of the patients' daily energy provision. RCTs with off-label interventions were excluded from the analysis.
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* Authors qualify this statement as being "...to the best of our knowledge..."
References
1. Pradelli L, Mayer K, Klek S et al. omega-3 Fatty-Acid Enriched Parenteral Nutrition in Hospitalized Patients: Systematic Review With Meta-Analysis and Trial Sequential Analysis. JPEN J Parenter Enteral Nutr. 2019.
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