Nutrition
Volume 26, Issue 5 , Pages 474-481, May 2010

Impact of lipid emulsion containing fish oil on outcomes of surgical patients: Systematic review of randomized controlled trials from Europe and Asia

  • Chen Wei, M.D.

      Affiliations

    • Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Beijing, People's Republic of China
    • ,
  • Jiang Hua, M.D.

      Affiliations

    • Department of Trauma Surgery, East Branch, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences, Chengdu, People's Republic of China
    • Corresponding Author InformationCorresponding author. Tel.: +86-28-8674-1981; fax: +86-28-8768-6307.
    • ,
  • Cai Bin, M.D.

      Affiliations

    • Department of Trauma Surgery, East Branch, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences, Chengdu, People's Republic of China
    • ,
  • Karen Klassen, B.Sc.

      Affiliations

    • Nutrition and Dietetics, St. Mary's Hospital, London, United Kingdom

Received 30 April 2009; accepted 17 September 2009. published online 29 January 2010.

Abstract 

Objective

This study aimed to systematically review the clinical efficacy of lipid emulsion containing fish oil in surgical patients.

Methods

Medline, SCI, Embase, Cochrane Library, and Chinese Biomedicine Database were searched for studies published before January 1, 2009 that were randomized controlled trials for postoperative patients. Parenteral nutrition with or without fish oil emulsion was the only difference between the intervention and control groups. Methodologic quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 and Jadad's score scale. RevMan 5.0 statistical software was used for meta-analysis.

Results

Six trials met all inclusion criteria and were enrolled for final meta-analysis. The aggregated results of the trails showed that fish oil was associated with no mortality advantage. There was a significant reduction in infectious complications in patients receiving fish oil (relative risk 0.49, 95% confidence interval 0.26–0.93, P=0.03). The result on length of hospital stay showed a trend of shortening by 3.06 d associated with receiving fish oil. However, the difference was not significant. When excluding one obviously heterogeneous study and aggregating the other three remaining studies, results showed significantly shortening of length of hospital stay associated with receiving fish oil. Fish oil also significantly shortened length of stay in the intensive care unit by 2.07 d.

Conclusion

The administration of lipid emulsion containing fish oil to patients undergoing elective major operations improves outcomes. The infectious complications are significantly fewer and length of hospitalization significantly shortened for patients treated with lipid emulsion containing fish oil. Further well-designed randomized controlled trials are needed to demonstrate the cost effectiveness of lipid emulsion containing fish oil to postoperative patients.

Keywords: Fish oil, Lipid emulsion, Parenteral nutrition, Postoperative patient, Systematic review, Outcomes

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PII: S0899-9007(09)00403-1

doi:10.1016/j.nut.2009.09.011

Nutrition
Volume 26, Issue 5 , Pages 474-481, May 2010

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