Are omega-3 fatty acids safe and effective in acute pancreatitis or sepsis? A systematic review and meta-analysis
Clinical Nutrition DOI: https://doi.org/10.1016/j.clnu.2019.12.006
Daniel R.J. Wolbrinka,∗,'Correspondence information about the author Daniel R.J. WolbrinkEmail the author Daniel R.J. Wolbrink, Jessica R. Grundsellb, Ben Wittemanc, Marcel van de Polld, Hjalmar C.van Santvoorte,f, Eyad Issag, Ashley Dennisong, Harry van Goora, Marc G. Besselinkb,1, Stefan A.W. Bouwensea,1 the Dutch Pancreatitis Study Group
- Sepsis is both prevented and treated by Vitamin D - many studies
- Sepsis reduced the Omega-3 response and half life – April 2019
Omega-3
- Sepsis mortality cut in half with Omega-3 – RCT Sept 2017
- Sepsis: 4 fewer days in ICU if add Omega-3 – meta-analysis of 12 RCT – June 2017
- Omega-3 reduced cost of Sepsis by 2900 dollars per patient (12 RCT) – April 2018
Pages in BOTH of the categories: Trauma/Surgery and Omega-3
- Omega-3 reduced pancreas transplant failure by 3X and sepsis by 2X – review Dec 2019
- Hospitalization costs reduced ~3,000 dollars when intravenous nutrition was augmented with Omega-3 – Aug 2019
- Omega-3 supplements taken before and after surgery actually helped – RCT Nov 2018
- ICU length of stay reduced when supplement with Omega-3 – meta-analysis July 2018
- 3 days of Omega-3 before cardiac surgery reduced risk of post-op bleeding by half – RCT March 2018
- Omega-3 benefits in surgery and ICU including via IV - March 2016
- Omega-3 reduced time in hospital and atrial fibrillation after cardiac surgery – meta-analysis May 2016
- 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
- Cognitive decline after traumatic brain injury reduced by Omega-3 (mice) – Nov 2016
- Football Brain injuries prevented by Omega-3 – RCT Jan 2016
- Omega-3 should be cost-effective to reduce days in ICU – simulation June 2015
Background
Acute pancreatitis (AP) is marked by a strong pro-inflammatory response, which may cause a systemic inflammatory response syndrome (SIRS), organ failure, and death. Early administration of omega-3 fatty acids (FA) may reduce the pro-inflammatory response and improve outcome in AP. A systematic review focusing on the safety and efficacy of omega-3 FA in AP is lacking.
Aim: Evaluate the safety and efficacy of an intervention with omega-3 FA in acute pancreatitis and sepsis.
Methods
A systematic review and meta-analysis was performed using the PubMed, Embase, and Cochrane databases including only randomized controlled trials in AP and, for safety endpoints, in sepsis investigating intervention including omega-3 FA without other active components (e.g. addition of glutamine to the intervention). The primary outcome was mortality.
Results
After screening 1186 studies, five randomized trials (n = 229) with omega-3 FA in AP were included. In AP patients treated with omega-3 FA within 48 h after hospitalization, a non-significant reduction of mortality was seen (OR 0∙50, 95%CI 0∙13–1∙99, p = 0∙33), compared to controls. In two studies (n = 85), omega-3 FA reduced the risk of new onset of organ failure (OR 0∙33, 95%CI 0∙12–0∙93, p = 0∙04). Nine randomized trials with 312 patients suffering from sepsis (not pancreatitis related) demonstrated a reduced mortality (OR 0∙52, 95%CI 0∙28–0∙97, p = 0·04). None of these 14 randomized trials reported safety concerns.
Conclusions
Administration of omega-3 FA could reduce the risk of new-organ failure in patients with AP. There were no safety issues reported of the early administration of omega-3 FA in any of the included studies. To show the real clinical benefit of omega-3 FA in AP, a large and pragmatic randomized controlled trial is needed.