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含鱼油营养补充剂对成年脓毒症患者的影响:一项系统评价与荟萃分析

Effects of fish oil-containing nutrition supplementation in adult sepsis patients: a systematic review and meta-analysis.

作者信息

Wang Hongyu, Su Sen, Wang Chao, Hu Jianhong, Dan Wu, Peng Xi

机构信息

Clinical Medical Research Center, Southwest Hospital, The Third Military Medical University, Chongqing 400000, China.

Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, The Third Military Medical University, Chongqing, China.

出版信息

Burns Trauma. 2022 Jun 10;10:tkac012. doi: 10.1093/burnst/tkac012. eCollection 2022.

Abstract

BACKGROUND

Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Although fish oil has been used as an immunonutritional preparations for the treatment of sepsis patients, there is still controversy as to whether it is beneficial to them. We systematically reviewed published clinical trial data to evaluate the effectiveness of fish oil-containing nutrition supplementation in sepsis patients.

METHODS

A systematic search was undertaken in PubMed, Embase, Chinese Biomedicine Database, the Cochrane Library and the China Knowledge Resource Integrated Database to obtain clinical controlled trails. RCTs on nutrition therapy containing fish oil among adult sepsis patients were selected for analysis in comparison with routine therapy.

RESULTS

Twenty-five published trials were included in the meta-analysis. Fish oil-containing nutrition supplementation reduced the mortality compared with the control group (relative risk (RR) 0.74,  = 0%). Fish oil also shortened the ICU stay (MD -3.57 days; 95% CI -4.54, -2.59; <0.00001;  = 76%), hospital stay (MD -9.92 days; 95% CI -15.37, -4.46;  = 0.0004;  = 91%) and the duration of mechanical ventilation support (MD -2.26; 95% CI -4.27, -0.26;  = 0.03;  = 83%). A subgroup analysis based on the route of administration revealed that parenteral administration of fish oil could reduce mortality in septic patients (RR =0.68,  = 0%), but no significant difference in mortality was observed in the fish oil group administered by enteral route (RR = 0.80,  = 0%). No statistically significant publication biases were detected for the above clinical endpoints (>0.05).

CONCLUSIONS

Parenteral nutrition containing fish oil could significantly decrease mortality in sepsis patients while enteral administration could not. Fish oil-containing nutrition supplementation.

摘要

背景

脓毒症是由宿主对感染的反应失调引起的危及生命的器官功能障碍。尽管鱼油已被用作免疫营养制剂来治疗脓毒症患者,但对于其是否对患者有益仍存在争议。我们系统回顾已发表的临床试验数据,以评估含鱼油营养补充剂对脓毒症患者的有效性。

方法

在PubMed、Embase、中国生物医学数据库、Cochrane图书馆和中国知网数据库中进行系统检索,以获取临床对照试验。选择成年脓毒症患者中含鱼油营养治疗的随机对照试验与常规治疗进行比较分析。

结果

荟萃分析纳入了25项已发表的试验。与对照组相比,含鱼油营养补充剂降低了死亡率(相对危险度(RR)0.74,P = 0%)。鱼油还缩短了重症监护病房(ICU)住院时间(MD -3.57天;95%置信区间-4.54,-2.59;P<0.00001;I² = 76%)、住院时间(MD -9.92天;95%置信区间-15.37,-4.46;P = 0.0004;I² = 91%)以及机械通气支持时间(MD -2.26;95%置信区间-4.27,-0.26;P = 0.03;I² = 83%)。基于给药途径的亚组分析显示,肠外给予鱼油可降低脓毒症患者的死亡率(RR = 0.68,P = 0%),但肠内给予鱼油组的死亡率无显著差异(RR = 0.80,P = 0%)。对于上述临床终点,未检测到统计学显著的发表偏倚(P>0.05)。

结论

含鱼油的肠外营养可显著降低脓毒症患者的死亡率,而肠内给予则不能。含鱼油营养补充剂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a5a/9185164/4ec6f4e4b160/tkac012f1.jpg

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