The efficacy and acceptability of anti-inflammatory omega-3 polyunsaturated fatty acid supplements in sepsis management: a network meta-analysis of randomized controlled trials

Ping-Tao Tseng , Bing-Yan Zeng , Bing-Syuan Zeng , Pin-Yang Yeh , Brendon Stubbs , John S. Kuo , Cheuk-Kwan Sun , Yu-Shian Cheng , Yen-Wen Chen , Tien-Yu Chen , Yi-Cheng Wu , Yu-Kang Tu , Pao-Yen Lin , Dian-Jeng Li , Chih-Sung Liang , Mein-Woei Suen , Yi-Che Lee , Wei-Chieh Yang , Chih-Wei Hsu , Yow-Ling Shiue , Kuan-Pin Su
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Abstract

Sepsis is a critical medical condition associated with high mortality for patients. Current pharmacological strategies for sepsis management or prevention had not achieved satisfactory results. The omega-3 fatty acids, with anti-inflammatory benefits, are considered to be promising agents for sepsis management/prevention. The aim of this network meta-analysis (NMA) is to compare the efficacy of various dosages and formulations of fish oil supplements for sepsis management and sepsis prevention. The current NMA consisted of two parts: (1) sepsis management and (2) sepsis prevention. The PubMed, ClinicalKey, Embase, ProQuest, Cochrane CENTRAL, ScienceDirect, Web of Science, and ClinicalTrials.gov databases were systematically searched to date of February 22nd, 2024 for relevant randomized controlled trials (RCTs). RCTs were eligible for inclusion if they enrolled participants with a diagnosis of sepsis or who with high risk for sepsis. All NMA procedures were conducted under the frequentist model. The primary outcomes assessed are (1) mortality rate in sepsis treatment or (2) incidence of sepsis in sepsis prevention. Our NMA, based on 28 RCTs and 1718 participants (mean age=51.6 years, mean female proportion=35.6 %), showed that (1) high dose parenteral fish oil supplement yield the lowest mortality rate in sepsis management in adult patients, and (2) high dose enteral fish oil supplement yield the lowest incidence of sepsis in pediatric patients. This study provides compelling evidence that high-dose fish oil supplements provide beneficial effects for both sepsis management and sepsis prevention. Our findings provide a preliminary rationale for future large-scale RCTs to investigate the role of fish oil supplementation in sepsis management or prevention.

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抗炎性欧米伽-3 多不饱和脂肪酸补充剂在败血症治疗中的疗效和可接受性:随机对照试验的网络荟萃分析
败血症是一种危重病,患者死亡率很高。目前治疗或预防败血症的药物策略并未取得令人满意的效果。具有抗炎功效的欧米伽-3 脂肪酸被认为是治疗/预防败血症的有效药物。本网络荟萃分析(NMA)旨在比较各种剂量和配方的鱼油补充剂对败血症治疗和预防的功效。目前的 NMA 包括两部分:(1) 败血症治疗和 (2) 败血症预防。截至 2024 年 2 月 22 日,我们在 PubMed、ClinicalKey、Embase、ProQuest、Cochrane CENTRAL、ScienceDirect、Web of Science 和 ClinicalTrials.gov 数据库中系统检索了相关的随机对照试验 (RCT)。如果随机对照试验的参与者确诊患有脓毒症或脓毒症风险较高,则符合纳入条件。所有 NMA 程序均在频数模型下进行。评估的主要结果是:(1)脓毒症治疗中的死亡率;或(2)脓毒症预防中的脓毒症发病率。我们的 NMA 基于 28 项 RCT 和 1718 名参与者(平均年龄=51.6 岁,平均女性比例=35.6%),结果显示:(1)在成人患者的脓毒症治疗中,高剂量肠外鱼油补充剂的死亡率最低;(2)在儿童患者中,高剂量肠内鱼油补充剂的脓毒症发病率最低。这项研究提供了令人信服的证据,证明高剂量鱼油补充剂对败血症治疗和败血症预防都有益处。我们的研究结果为今后开展大规模 RCT 研究鱼油补充剂在败血症治疗或预防中的作用提供了初步依据。
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来源期刊
Prostaglandins, leukotrienes, and essential fatty acids
Prostaglandins, leukotrienes, and essential fatty acids Clinical Biochemistry, Endocrinology, Diabetes and Metabolism
CiteScore
5.30
自引率
0.00%
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0
审稿时长
64 days
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