Table 2 Characteristics of included studies
Study/time | Cases(n/N)a | Critical score | Included patients | Treatment duration | Randomized methods | Blinding | Nutrition supplement in control group | Nutrition supplement in experimental group | Comparison methodb |
|---|---|---|---|---|---|---|---|---|---|
Wang 2014 [51] | 53(25/23) | – | Severe abdominal infection-inducedd sepsis | 5 days | Did not depict | No. | TPN application in 24–48 h after admission. Carole: 25 kcal/(kg ⋅ day), AA 1.2 g/(kg ⋅ day) | Plus Omegaven 0.2 g/(kg ⋅ day) based on nutrition in control group | A + B/A |
Zhao 2012c [52] | 126(62/64) | APACHE II 21.1 | Sepsis | 7 days | Did not depict | No | Mixed feeding (specific unknown) | Omegaven 100 mL/day | A + B/A |
Liang 2009c [53] | 148(70/78) | APACHE II 24.5 | Pneumonia induced sepsis | 7 days | Did not depict | No | Soybean fatty acid | Soybean fatty acid plus Omegaven 100 mL/day | A + B/A |
Zhao 2011c [29] | 102(49/53) | APACHE II 21.1 | Sepsis induced ARDS | 7 days | Did not depict | No | Mixed feeding | Plus Omegaven 100 mL/day | A + B/A |
Qu 2009c [54] | 40(20/20) | Mean APACHE II 17.7 | Sepsis-induced gastrointestinal dysfunction | 5 days | Did not depict | No | TPN 83.65 kJ/kg with nitrogen 0.2 g/kg | Plus Omegaven 1–2 mL/(kg ⋅ day) | A + B/A |
Chen 2011c [21] | 30 (15/15) | Mean APACHE II 15.13/Mean Marshall Score 6.27 | Sepsis-induced gastrointestinal dysfunction (with China diagnosis criteria) | 7 days | Random-numbers table | No | LCT/MCT 20 kcal/(kg ⋅ day) | Plus Omegaven 100 mL/day | A + B/A |
Chen 2017c [22] | 40 (20/20) | Mean APACHE II 23.4/Mean Marshall Score 9.8 | Sepsis-induced gastrointestinal dysfunction (with China diagnosis criteria) | 7 days | Random-numbers table | No | LCT/MCT 20 kcal/(kg ⋅ day) | Plus Omegaven 100 mL/day | A + B/A |
Chen02 2017c [23] | 78 (41/37) | Mean APACHE II 32/Mean Marshall Score 9.3 | Sepsis-induced gastrointestinal dysfunction (with Europe diagnosis criteria) | The whole duration in ICU. | Random-numbers table | No | LCT/MCT 20 kcal/(kg ⋅ day) | Plus Omegaven 100 mL/day | A + B/A |
Burkhart 2014c [55] | 50 (25/25) | Mean APACHE II 26 | Sepsis | 7 days | Computer-based system | Yes (sealed envelopes) | Standard treatment (enteral/parenteral nutritional therapy but did not contain additional n-3 fatty acid) | Omegaven 0.2 g/(kg â‹… day) or n-3 fatty acids 0.12 mg/(kg â‹… day) | A/B |
Hall 2015c [56] | 60 (30/30) | Mean APACHE II 19/Mean SOFA score 7.3 | Sepsis (initiate within 12 h) | 14 days or the whole duration if earlier | Random-numbers table | Yes (sealed envelopes) | Standard medical care only | 0.2 g Omegaven/(kg â‹… day) (0.05 g/(kg â‹… h)) | A/B |
Rice 2011c [30] | 272 (143/129) | Mean APACHE III 93.8 | Acute lung injury (ALI) Patients had to receive mechanical ventilation | 21 days | 2a2 factorial design | No | Control supplement | n-3 enriched enteral formula | A + B/A |
Pontes-Arruda 2011c [57] | 115 (57/58) | Mean SOFA score 8.8 | Early sepsis and required enteral nutrition | 7 days | Web-based central randomization system | Yes (double blind) | Control enteral diet (ensure Plus HN), which did not contain DHA/EPA/GLA n-3:n-6 = 1:3.8 | Study enteral diet (Oxepa) n-3:n-6 = 1:1.85 | A + B/A + B |
Grau-Carmona 2011c [31] | 132 (61/71) | Mean APACHE II 19/Mean SOFA score 9 | Sepsis, mechanical ventilation; could receive EN | 16 days | Computer-generated random-numbers table | Yes | Control diet n-6:n-3 = 5.8:1 | EPA-GLA diet n-6:n-3 = 1.5:1 | A + B/A + B |
Barbosa 2010 [58] | 25 (13/10) | – | SIRS or sepsis (who were predicted to need PN: severe pancreatitis, MODS, excisional surgery) | 6 days | Random-numbers table | Yes (sealed envelopes) | 50:50 mixture of an oil rich in medium-chain fatty acids Soybean (termed as MCT/LCT) Nutriflex Lipid Special | 50:40:10 mixture of an oil rich in medium-chain fatty acids, soybean oil, and fish oil Lipolus, B. Braun, Portugal | A + B/A |
Wang 2008c [59] | 40 (20/20) | Mean APACHE II 13/Mean SOFA score 7 | Severe acute pancreatitis | 5 days | Computer-derived block randomization | Yes (Double blind) | SO (Lipovenoes 20%; Fresenius, Germany) | FO-supplemented SO (Omegaven 10%; Fresenius, Germany) n-3:n-6 = 1:4 | A + B/A |
Friesecke 2008 [60] | 166 (83/83) One in the control group was lost to follow-up. | – | Critical care patients with/without SIRS | 7 days | Did not depict | Yes (double blind) | Lipofundin MCT (Deltamin, Deltaselect, Dreieich, Germany) | Omegaven (Fresenius Kabi) and Lipofundin MCT n-3:n-6 = 1:2 | A + B/A |
Pontes-Arruda 2006c [32] | 103 (55/48) | Mean APACHE II 19.5 /Mean SOFA score 5.5 | Either severe sepsis or septic shock requiring mechanical ventilation | 7 days | Did not depict | Yes (Double blind) | High-fat, low-carbohydrate enteral formulation n-3:n-6 = 3.8:1 | Diet enriched with EPA, GLA, and enhanced levels of antioxidant vitamins. n-6:n-3 = 1.85:1 | A + B/A + B |
Mayer 2003c [61] | 21 (10/11) | Mean APACHE II 19.6 | Sepsis and SIRS | 5 days | Did not depict | No | Standard n-6 lipid infusion (Lipoven; Fresenius Kabi, Germany) | n-3 lipid infusion (Omegaven; Fresenius Kabi, Germany) | A/B |
Galbán 2000 [62] | 181 (94/87) | – | Sepsis, with APACHE II score more than 10 | 17 days | Computer-generated randomization program | No | High-protein control feed (Precitene Hiperproteico) 1414 ± 471 kcal/day | Enteral feed enriched with arginine, mRNA, and ω-3 fatty acid from fish oil 1231 ± 411 kcal/day | A + B/A + B |
Gadek 1999 [33] | 98 (51/47) | – | ARDS caused by sepsis/pneumonia, trauma, or aspiration injury | 7 days | A permuted-block randomization design | Yes (double blind) | High-fat, low-carbohydrate enteral nutrition formula | EPA + GLA enteral diet | A + B/A + B |
Weimann 1998 [63] | 29 (16/13) | Mean APACHE II 6.5 | SIRS and MODS after severe trauma | 31 days | Did not depict | Yes (double blind) | Control | IMPACT formula with 10.5% omega-3 fatty acid (Sandoz Nutrition, Berne, Switzerland) | A + B/A |
Bower 1995c [64] | 296 (167/159) | Mean APACHE II 19.2 | Critical care patients, including severe trauma, sepsis, SIRS | 7 days | Computer-generated randomization program | Yes (double blind) | Conventional nutrition formula (Osmolite HN, Ross Laboratories, OH, USA) | RNA, Mwer oil (Impact, Sandoz Nutrition, MN, USA) | A + B/A + B |
Gultekin 2014 [65] | 32 (16/16) With mean age of 62.9 ± 12.2 years | – | Sepsis | 5 days | Did not depict | Yes (double blind) | Olive oil containing standard lipid emulsion (1.3 ± 0.1 g/(kg ⋅ day)) | TPN: 80% olive oil + 20% soy oil + 10 g fish oil (10% Omegaven, Fresenius Kabi, Germany) | A + B/A |
Shirai 2015c [34] | 46 (23/23) | Mean APACHE II 24/Mean SOFA score 10 | Sepsis-induced ARDS | 14 days | Did not depict | Yes (single blind) | A standard isocaloric enteral diet | Enteral diet enriched with EPA, GLA, and antioxidants | A + B/A + B |
Hosny 2013c [66] | 75 (25/25/25) High-dose group = 25 Control group = 25 | Mean SOFA score 3.7 | Early stage of sepsis | 7 days | Did not depict | No | Conventional sepsis treatment | High-dose omega-3 fatty acids; antioxidants in the form of ascorbic acid 1000 mg/day | A/B |