Summary of findings 2. Fish oil lipid emulsion (LE) compared to another fish oil LE for parenterally fed preterm infants.
| Fish oil LE compared to another fish oil LE for parenterally fed preterm infants | ||||||
| Patient or population: parenterally fed preterm infants Settings: neonatal intensive care unit Intervention: fish oil LE (MOFS‐LE) Comparison: another fish oil LE (MFS‐LE) | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Other fish oil LE | Fish oil LE | |||||
|
Growth rate – MOFS‐LE vs MFS‐LE |
— | The mean rate of weight gain in the intervention groups was 4 g/kg/day higher (2.03 lower to 10.03 higher) | — | 55 (1 study) | ⊕⊕⊝⊝ Lowa,b | — |
|
PNALD/cholestasis (conjugated bilirubin ≥ 2 mg/dL) – MOFS‐LE vs MFS‐LE |
Study population | RR 0.96 (0.06 to 14.65) | 55 (1 study) | ⊕⊕⊝⊝ Lowa,b | — | |
| 37 per 1000 | 36 per 1000 (2 to 543) | |||||
|
Death before discharge – MOFS‐LE vs MFS‐LE |
Study population | RR 1 (0.15 to 6.64) | 60 (1 study) | ⊕⊕⊝⊝ Lowa,b | — | |
| 67 per 1000 | 67 per 1000 (10 to 443) | |||||
|
CLD (oxygen requirement at 36 weeks' postmenstrual age) – MOFS‐LE vs MFS‐LE |
Study population | RR 1.16 (0.4 to 3.35) | 55 (1 study) | ⊕⊕⊝⊝ Lowa,b | — | |
| 185 per 1000 | 215 per 1000 (74 to 620) | |||||
|
Any sepsis (clinical or culture positive (or both)) – MOFS‐LE vs MFS‐LE |
Study population | RR 1.69 (0.56 to 5.11) | 55 (1 study) | ⊕⊕⊝⊝ Lowa,b | — | |
| 148 per 1000 | 250 per 1000 (83 to 757) | |||||
|
Conjugated bilirubin levels – MOFS‐LE vs MFS‐LE |
— | The mean conjugated bilirubin levels in the intervention group was 1.4 µmol/L lower (6.4 lower to 3.6 higher) | — | 55 (1 study) | ⊕⊕⊝⊝ Lowa,b | — |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; CLD: chronic lung disease; LE: lipid emulsion; MFS‐LE: medium‐chain triglyceride‐fish‐soybean lipid emulsion; MOFS‐LE: medium‐chain triglycerides (MCT)‐olive‐fish‐soybean oil‐lipid emulsion; PNALD: parenteral nutrition‐associated liver disease; RR: risk ratio. | ||||||
| GRADE Working Group Grades of Evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | ||||||
aDowngraded by one level as optimal information size not reached. bDowngraded by one level as the CI crossed the null effect and the limit of appreciable harm or benefit (0.75 or 1.25); or crossed limit of clinically appreciable harm or benefit in a continuous outcome (author consensus).