Table 1.
Characteristics of the Randomized Controlled Trials Included (n = 49), Showing Extracted Outcomes
Randomized Control Trial | Patient Type (Number Randomized)a | ω‐3‐Enriched Lipid Emulsion | Standard Lipid Emulsion | Primary and Secondary Clinical Outcomesb | Laboratory Outcomes |
---|---|---|---|---|---|
ICU patients | |||||
Antebi et al, 200417 | Major surgery (n = 20) | SO/MCT/OO/FO | SO | Alpha‐T, ALT, AST, CRP, GGT, TG | |
Barbosa et al, 201018 | SIRS or sepsis (n = 23, received study treatments) | SO/MCT/FO | SO/MCT | Mortality, H LOS, ICU LOS | AA, ALT, AST, bilirubin, CRP, DHA, EPA, GGT, IL‐6, Lac, LTB4, OI, PTT, Plt, TNF |
Berger et al, 200819 | Abdominal aortic aneurism surgery (n = 24, completed trial) | SO/MCT/FO | SO/MCT | Mortality, H LOS, ICU LOS | AA, alpha‐T, CRP, DHA, EPA, TG |
Chen et al, 201720 | Severe sepsis with Grade III acute gastrointestinal injury (n = 78) | SO/FO | SO | Mortality | CRP |
Chen et al, 201721 | Patients with septicaemia and intestinal dysfunction (n = 48) | Standard TPN/FO | Standard TPN | Mortality, ICU LOS | CRP |
Friesecke et al, 200822 | Critically ill medical (n = 165) | SO/MCT/FO | SO/MCT | Mortality, infections, H LOS, ICU LOS, bleeding events | IL‐6, TBU |
Grau‐Carmona et al, 201523 | Medical and surgical ICU patients (n = 175) | SO/MCT/FO | SO/MCT | Mortality, infections, H LOS, ICU LOS | |
Gultekin et al, 201424 | ICU patients with sepsis (n = 32) | SO/OO/FO | SO/OO | Mortality, H LOS | CRP, IL‐6, LTB4, TG, TNF |
Han et al, 201225 | Major surgery (n = 38) | SO/MCT/FO | SO/MCT | Infections | IL‐6, TNF |
Heller et al, 200226 | Cancer, major abdominal surgery (n = 44) | SO/FO | SO | Plt, PT, PTT | |
Heller et al, 200427 | Cancer, major abdominal surgery (n = 44) | SO/FO | SO | H LOS, ICU LOS | ALT, AST, bilirubin, CRP |
Morlion et al, 199628 | Major abdominal surgery (n = 20) | SO/FO | SO | AA, DHA, EPA, LTB4, LTB5 | |
Piper et al, 200929 | Major abdominal or craniomaxillofacial surgery (n = 44) | SO/MCT/OO/FO | SO/OO | ALT, AST, Plt, TG | |
Roulet et al, 199730 | Cancer, esophagectomy (n = 19, completed trial) | SO/FO | SO | AA, DHA, EPA, BT | |
Sabater et al, 201131 | ARDS (n = 16) | SO/MCT/FO | SO | Mortality | LTB4 |
Stephenson et al, 201332 | Surgery for hepatic colorectal metastasis (n = 20) | SO/MCT/FO | SO/MCT | AA, DHA, EPA | |
Wachtler et al, 199733 | Cancer, major intestinal surgery (n = 40) | SO/MCT/FO | SO/MCT | Infections, H LOS, ICU LOS | IL‐6, LTB4, LTB5, LTB ratio, TNF |
Wang et al, 200834 | Severe acute pancreatitis (n = 40) | SO/FO | SO | Mortality, infections, H LOS, ICU LOS, sepsis | CRP, EPA, IL‐6, OI |
Wang et al, 200935 | Severe acute pancreatitis (n = 56) | SO/FO | SO | Mortality, infections | |
Weiss et al, 200236 | Gastrointestinal surgery (n = 24) | SO/FO | SO | Mortality, infections, H LOS, ICU LOS | IL‐6, TNF |
Wendel et al, 200737 | Cancer, major abdominal surgery (n = 44) | SO/FO | SO | TG | |
Wichmann et al, 200738 | Major intestinal surgery (n = 256) | SO/MCT/FO | SO | Mortality, infections, H LOS, ICU LOS, sepsis | Alpha‐T, AST, bilirubin, Cr, CRP, EPA, GGT, LTB5, LTB ratio, Plt, PT, TG |
Surgical patients | |||||
Aliyazicioglu et al, 201339 | Colorectal cancer surgery (n = 36) | Standard TPN/FO | Standard TPN | H LOS | |
Badia‐Tahull et al, 201040 | Major intestinal surgery (n = 29) | SO/FO | SO/OO | Mortality, infections, H LOS, sepsis | ALT, Cr, CRP, GGT, PU, TBU |
Chen et al, 201741 | Gastric cancer surgery (n = 120) | SO/MCT/OO/FO | SO | Infections, H LOS | ALT, bilirubin, CRP, IL‐6 |
Demirer et al, 201642 | Major abdominal surgery (n = 52) | SO/OO/FO | SO/OO or SO/MCT | CRP, IL‐6, TNF | |
Grimm et al, 200643 | Major abdominal surgery (n = 33) | SO/MCT/OO/FO | SO | H LOS | AA, alpha‐T, DHA, EPA, LTB4, LTB5, LTB ratio |
Hallay et al, 201044 | Gastrointestinal surgery (n = 41) | SO/MCT/OO/FO | SO/MCT | ALT, AST, bilirubin, GGT | |
Jiang et al, 201045 | Gastrointestinal cancer surgery (n = 206) | SO/FO | SO | Infections, H LOS, sepsis | Cr, IL‐6, TNF |
Klek et al, 200546 | Gastric cancer surgery (n = 105, enrolled) | SO/MCT/FO | SO/MCT | Infections, H LOS | ALT, AST, Cr, PU |
Klek et al, 200847 | Gastrectomy or pancreaticoduodenectomy (n = 205) | SO/MCT/FO (plus glutamine) | SO/MCT | Mortality, infections, H LOS, sepsis | |
Klek et al, 201148 | Gastrectomy or pancreaticoduodenectomy (n = 167) | SO/MCT/FO (plus glutamine) | SO/MCT | Mortality, infections, sepsis | |
Koller et al, 200349 | Major abdominal surgery (n = 30) | SO/MCT/FO | SO | LTB4, LTB5, LTB ratio | |
Liang et al, 200850 | Radical colorectal cancer resection (n = 41) | SO/FO | SO | Mortality, infection, H LOS | GGT, IL‐6, Plt, TNF |
Linseisen et al, 200051 | Major abdominal surgery (n = 33) | SO/MCT/FO | SO | AA, alpha‐T, DHA, EPA | |
Ma et al, 201252 | Gastrointestinal tumor surgery (n = 40) | SO/MCT/OO/FO | SO/MCT | H LOS | ALT, AST, bilirubin, Cr, CRP, IL‐6, PU, TG, TNF |
Ma et al, 201553 | Gastric and colorectal cancer surgery (n = 99) | SO/MCT/FO | SO/MCT | Infections | ALT, AST, bilirubin, CRP, GGT, IL‐6, TG, TNF |
Makay et al, 201154 | Major gastric cancer surgery (n = 26) | SO/FO | SO | Mortality, infections, H LOS | ALT, AST, Cr, Lac, PU |
Mertes et al, 200655 | Abdominal or thoracic surgery (n = 249) | SO/MCT/OO/FO | SO | Mortality, H LOS | ALT, AST, bilirubin, GGT, TG |
Schauder et al, 200256 | Large bowel surgery (n = 60) | SO/FO | SO | TNF | |
Senkal et al, 200757 | Colorectal surgery (n = 40, received study treatments) | SO/MCT/FO | SO/MCT | Infections | AA, DHA, EPA |
Wang et al, 201258 | Gastrointestinal surgery (n = 64) | SO/MCT/FO | SO/MCT | Infections, sepsis | ALT, AST, bilirubin, CRP, GGT, IL‐6, LTB ratio, Plt, PT, PTT, TG, TNF |
Wei et al, 201459 | Surgical resection of gastric tumors (n = 52) | SO/FO | SO | Infections | CRP, IL‐6, TNF |
Wu et al, 201460 | Gastrointestinal surgery (n = 40) | SO/MCT/OO/FO | SO/MCT | Infections, H LOS | ALT, AST, bilirubin, Cr, CRP, GGT, IL‐6, PU, TG, TNF |
Zhang et al, 201761 | Hepatectomy (n = 320) | SO/MCT/FO | SO/MCT | Mortality, infections, H LOS, sepsis | ALT, bilirubin, Cr, CRP, TG, Plt, PU, PTT |
Zhixue et al, 201862 | Liver cancer surgery (n = 75) | SO/MCT/FO | SO/MCT | IL‐6, TNF | |
Zhu et al, 201263 | Liver transplant (n = 66) | SO/MCT/FO | SO/MCT | Mortality, infection, H LOS | ALT, AST, bilirubin, PT |
Zhu et al, 201264 | Colorectal cancer surgery (n = 57, completed trial) | SO/FO | SO | Infection, H LOS, sepsis | IL‐6, TNF |
Zhu et al, 201365 | Pancreaticoduodenectomy (n = 76) | SO/MCT/FO | SO/MCT | Mortality, infection, H LOS, hospital readmission | ALT, AST, bilirubin |
AA, (%) content of arachidonic acid in serum/cellular membranes; alpha‐T, alpha‐tocopherol; ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; BT, bleeding time; Cr, serum creatinine; CRP, C‐reactive protein; DHA, (%) docosahexaenoic acid content in serum/cellular membranes; EPA, (%) eicosapentaenoic acid content in serum/cellular membranes; FO, fish oil emulsion; Lac, lactate; GGT, γ‐glutamyl transferase; (H) LOS, (hospital) length of stay; ICU, intensive care unit; LTB, leukotriene B; LTB5:LTB4, LTB ratio; MCT, medium‐chain triglycerides; OI, oxygenation index; OO, olive oil emulsion; PU, plasma urea; Plt, Platelet; PT, prothrombin time; PTT, partial thromboplastin time; SIRS, systemic inflammatory response syndrome; SO, soybean oil emulsion; TBU, transfused blood unit; TGs, triglycerides; TNF, tumor necrosis factor.
Number of patients randomized was listed if available, but if not available an alternative descriptor was used for the patient population/number.
An outcome of sepsis included events defined by publication authors as septic or as systemic inflammatory response syndrome.