Intravenous fish oil lipid emulsions in critically ill patients: an updated systematic review and meta-analysis

Manzanares, William; Langlois, Pascal L; Dhaliwal, Rupinder; Lemieux, Margot; Heyland, Daren K

doi:10.1186/s13054-015-0888-7

Table 2 Outcomes of included trials on fish oil strategies using lipid emulsions^a

From: Intravenous fish oil lipid emulsions in critically ill patients: an updated systematic review and meta-analysis

Study	LOS in days		Ventilator days		Other
FO
Grecu *et al* ., 2003^b [62]	Omegaven (Fresenius Kabi, Bad Homburg, Germany)	LCT	Omegaven	LCT	Omegaven	LCT
	ICU	ICU	2.83 ± 1.62 (8)	5.23 ± 2.80 (7)	Patients undergoing reoperation for septic episode
	3.32 ± 1.48 (8)	9.28 ± 3.08 (7)			2/28 (7)	8/26 (31)
	Hospital	Hospital
	11.68 ± 2.04 (28)	20.46 ± 3.27 (26)
Friesecke *et al* ., 2008 [63]	FO	LCT	LCT + MCT + FO	LCT + MCT	LCT + MCT + FO	LCT + MCT
	ICU	ICU	22.8 ± 22.9 (83)	20.5 ± 19.0 (82)	Urinary tract infections
	28 ± 25 (83)	23 ± 20 (82)			6/83 (7)	4/82 (5)
					Catheter-related infections
					1/83 (1)	3/83 (4)
					Total EN energy intake (kcal/kg)
					22.2 ± 5.5	21.6 ± 5.6
Wang *et al* ., 2009 [61]	NR	NR	NR	NR	Omegaven	LCT
					Surgery of infected pancreatic necrosis
					3/28 (11)	6/28 (21)
Barbosa *et al* ., 2010 [64]	MCT + LCT + FO	MCT + LCT	MCT + LCT + FO	MCT + LCT	MCT + LCT+ FO	MCT + LCT
	ICU	ICU	10 ± 14.4 (13)	11 ± 12.64 (10)	2,057 ± 418 kcal	1,857 ± 255 kcal
	12 ± 14.4^c (13)	13 ± 12.6^c (10)
	Hospital	Hospital
	22 ± 25.2^c (13)	55 ± 50.6^c (10)
Gupta *et al* ., 2011 [15]	Omegaven	Standard EN	Omegaven	Standard EN
	ICU	ICU	11.78 ± 10.63 (31)	10.71 ± 14.55 (30)
	15.96 ± 7.57 (31)	15.88 ± 6.47 (30)
	Hospital	Hospital
	21.5 ± 13.49 (31)	26.63 ± 18.22 (30)
Khor *et al* ., 2011 [16]	Omegaven	Saline	Omegaven	Saline
	ICU	ICU	13.0 ± 10.1 (9)	11.6 ± 9.5 (5)
	10.3 ± 8.4 (14)	8.4 ± 6.5 (13)
	Hospital	Hospital
	19.6 ± 7.4 (14)	17.5 ± 6.0 (13)
Burkhart *et al* ., 2013 [18]	Omegaven	No Omegaven	NR	NR	Omegaven	No Omegaven
	ICU	ICU			Subsyndromal delirium
	5 (3 to 22)	6 (2 to 33)			5 (25)	6 (29)
					Sepsis associated delirium
					15 (75)	15 (71)
Grau-Carmona *et al* ., 2014 [65]	MCT + LCT + FO	MCT + LCT	MCT + LCT + FO	MCT + LCT	MCT + LCT+ FO	MCT + LCT
	ICU	ICU	8.41 ± 6.61	9.2 ± 6.0	Parenteral lipid intake [(g/kg BW)/d]
	18.9 ± 15.5	21.8 ± 20.9			1.04 ± 0.12	1.05 ± 0.13
	Hospital	Hospital			PN kcal
	41.1 ± 41.0	42.5 ± 28.5			1,737 ± 353	1,782 ± 312
Gultekin *et al* ., 2014 [66]	Omegaven + olive	Olive oil	NR	NR	Omegaven + olive oil	Olive oil
	Hospital	Hospital
	31.6 ± 4.3	30.6 ± 4.3			27.5 ± 1.5 kcal/kg/day	15.8 ± 1.5 kcal/kg/day
	31.6 ± 4.3	30.6 ± 4.3			1.3 ± 0.2 g protein/kg/day	1.1 ± 0.1 g protein/kg/day
Hall *et al* ., 2014 [17]	Omegaven	No Omegaven	NR (reported as free ventilator days)	NR (reported as free ventilator days)
	ICU	ICU
	8.8 ± 7.7	12.3 ± 12.4
	Hospital	Hospital
	26.7 ± 18.2	33.5 ± 30.4

^aThese studies compared fish oil (ω-3)–containing emulsions in parenteral nutrition–fed patients vs. LCT or LCT + MCT. EN, Enteral nutrition; FO, Fish oil; ICU, Intensive care unit; LCT, Long-chain triglycerides; MCT, Medium-chain triglycerides; ITT, Intention to treat; NR, Not reported. ^bData obtained from author, 8 of 28 in Omegaven (Fresenius Kabi, Bad Homburg, Germany) group and 7 of 26 in LCT group were in the ICU. ^cConverted standard error of the mean to standard deviation.

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