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Table 2 Characteristics of included studies

From: Correlation analysis of omega-3 fatty acids and mortality of sepsis and sepsis-induced ARDS in adults: data from previous randomized controlled trials

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 day) or n-3 fatty acids 0.12 mg/(kg 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 day) (0.05 g/(kg 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
  1. aCases: the total samples; n: samples in the treatment group; N: samples in the control group
  2. bComparison methods: A/B: directly compared two types of nutrition with or without n-3 fatty acids. A + B/A: comparison of n-6 fatty acids plus n-3 fatty acids to n-6 fatty acids alone. A + B/A + B: comparison of two types of nutrition with various concentrations of n-6 and n-3 fatty acids
  3. cRCTs including patients with APACHE II score more than 15, or SOFA score more than 2 were considered as similar baselines