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ω-3脂肪酸营养对脓毒症患者死亡率的影响:一项随机对照试验的荟萃分析

Effects of omega-3 fatty acid nutrition on mortality in septic patients: a meta-analysis of randomized controlled trials.

作者信息

Tao Wei, Li Ping-Song, Shen Zhou, Shu Yu-Sheng, Liu Sen

机构信息

Department of Burns and Plastic Surgery, Subei People's Hospital of Jiangsu province, Jiangsu, 225001, People's Republic of China.

Department of Outpatient, Subei People's Hospital of Jiangsu province, Jiangsu, 225001, People's Republic of China.

出版信息

BMC Anesthesiol. 2016 Jul 18;16(1):39. doi: 10.1186/s12871-016-0200-7.

Abstract

BACKGROUND

A previous systematic review and meta-analysis reported that omega-3 fatty acids nutrition may reduce mortality in septic patients. As new randomized controlled trials began to accumulate, we conducted an update.

METHODS

A PubMed database was searched through Feb 2016, and randomized controlled trials comparing omega-3 fatty acids with control were selected by two reviewers independently.

RESULTS

Eleven trials randomly assigning 808 patients were included in the present study. Using a fixed effects model, we found no significant effect of omega-3 fatty acids on overall mortality (risk ratio 0.84; 95 % confidence interval (CI): 0.67 to 1.05, P = 0.12), or infectious complications (risk ratio 0.95; 95 % CI: 0.72 to 1.25, P = 0.70). However, the duration of mechanical ventilation was markedly reduced by omega-3 fatty acids (weighted mean differences (WMD) = -3.82; 95 % CI: -4.61 to -3.04; P < 0.00001). A significant heterogeneity was found when the duration of hospital (I (2) = 93 %; WMD = -2.82; 95 % CI: -9.88 to 4.23, P = 0.43), or intensive care stay (I (2) = 87 %; WMD = -2.70; 95 % CI: -6.40 to 1.00, P = 0.15) were investigated.

CONCLUSIONS

Omega-3 fatty acids confer no mortality benefit but are associated with a reduction in mechanical ventilation duration in septic patients. However, low sample size and heterogeneity of the cohorts included in this analysis limits the generalizability of our findings.

摘要

背景

一项既往的系统评价和荟萃分析报告称,ω-3脂肪酸营养可能降低脓毒症患者的死亡率。随着新的随机对照试验开始积累,我们进行了一次更新。

方法

检索截至2016年2月的PubMed数据库,由两名审阅者独立选择比较ω-3脂肪酸与对照组的随机对照试验。

结果

本研究纳入了11项随机分配808例患者的试验。采用固定效应模型,我们发现ω-3脂肪酸对总体死亡率(风险比0.84;95%置信区间(CI):0.67至1.05,P = 0.12)或感染性并发症(风险比0.95;95%CI:0.72至1.25,P = 0.70)无显著影响。然而,ω-3脂肪酸显著缩短了机械通气时间(加权平均差(WMD)=-3.82;95%CI:-4.61至-3.04;P < 0.00001)。在研究住院时间(I² = 93%;WMD = -2.82;95%CI:-9.88至4.23,P = 0.43)或重症监护病房停留时间(I² = 87%;WMD = -2.70;95%CI:-6.40至1.00,P = 0.15)时发现了显著的异质性。

结论

ω-3脂肪酸对脓毒症患者无死亡率益处,但与机械通气时间缩短有关。然而,本分析中纳入队列的样本量小和异质性限制了我们研究结果的普遍性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05a8/4950703/6bd76e89e726/12871_2016_200_Fig1_HTML.jpg

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