Omega-3 supplementation in patients with sepsis: a systematic review and meta-analysis of randomized trials
Annals of Intensive Care 20177:58, DOI: 10.1186/s13613-017-0282-5©
Clara Lu, Sunjay Sharma, Lauralyn McIntyre, Andrew Rhodes, Laura Evans, Saleh Almenawer, Lori Leduc, Derek C. Angus and Waleed Alhazzani
Study does not mention how much Omega-3 was used, nor for how many days
- Vitamin D reduces sepsis 8 fewer ICU days with Vitamin D – RCT
Wonder how many fewer days if use BOTH Vitamin D and Omega-3
- Overview: Omega-3 many benefits include helping vitamin D
- Sepsis reduced the Omega-3 response and half life – April 2019
- Omega-3 reduced pancreas transplant failure by 3X and sepsis by 2X – review Dec 2019
- Vitamin D reduces inflammation in critically ill patients – Sept 2020
- Role and Mechanism of Vitamin D in Sepsis (Chinese) – Feb 2020
- Vitamin D, glutathione, and heat shock protein to treat concussions, etc. – US Patent Dec 2019
- Septic children have low Vitamin D (54 studies, ignored Vitamin D Receptor) – meta-analysis April 2019
- Urinary sepsis – a single Vitamin D injection reduced hospital days by 40 percent – RCT April 2018
- Vitamin D deficiency with severe sepsis increased risk of dying by 7.7 X – Nov 2017
- Severe sepsis may be prevented by 400,000 IU of vitamin D – RCT 2023
- Sepsis was present in 6 percent of US adult hospitalizations – JAMA Oct 2017
- 2.7 fewer days in hospital after surgery if had taken Omega-3 (19 RCT) – meta-analysis – June 2017
- Sepsis: 4 fewer days in ICU if add Omega-3 – meta-analysis of 12 RCT – June 2017
- Pro-inflammatory cytokines cause the 74 percent drop in vitamin D after knee arthroplasty – Feb 2014
- Critically ill patients with low vitamin D were 13X more likely to have a lot of mitrocondrial DNA in blood – Sept 2014
- More sepsis deaths when active vitamin D (Calcitrol) was low – May 2013
- Vitamin D decrease during inflammation is probably due to interferons - Oct 2012
- Vitamin D reduces sepsis
- Inflammation or surgery or heart attack decreases measured vitamin D levels – Mar 2011
Nutritional supplementation of omega-3 fatty acids has been proposed to modulate the balance of pro- and anti-inflammatory mediators in sepsis. If proved to improve clinical outcomes in critically ill patients with sepsis, this intervention would be easy to implement. However, the cumulative evidence from several randomized clinical trials (RCTs) remains unclear.
We searched the Cochrane Library, MEDLINE, and EMBASE through December 2016 for RCTs on parenteral or enteral omega-3 supplementation in adult critically ill patients diagnosed with sepsis or septic shock. We analysed the included studies for mortality, intensive care unit (ICU) length of stay, and duration of mechanical ventilation, and used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the quality of the evidence for each outcome.
A total of 17 RCTs enrolling 1239 patients met our inclusion criteria. Omega-3 supplementation compared to no supplementation or placebo had no significant effect on mortality [relative risk (RR) 0.85; 95% confidence interval (CI) 0.71, 1.03; P = 0.10; I 2 = 0%; moderate quality], but significantly reduced ICU length of stay [mean difference (MD) −3.79 days; 95% CI −5.49, −2.09; P < 0.0001, I 2 = 82%; very low quality] and duration of mechanical ventilation (MD −2.27 days; 95% CI −4.27, −0.27; P = 0.03, I 2 = 60%; very low quality). However, sensitivity analyses challenged the robustness of these results.
Omega-3 nutritional supplementation may reduce ICU length of stay and duration of mechanical ventilation without significantly affecting mortality, but the very low quality of overall evidence is insufficient to justify the routine use of omega-3 fatty acids in the management of sepsis.
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