title: Impact of lipid emulsion containing fish oil on outcomes of surgical patients: systematic review of randomized controlled trials from Europe and Asia.
abstract: OBJECTIVE
  This study aimed to systematically review the clinical efficacy of lipid emulsion containing fish oil in surgical patients.
  
  
  METHODS
  Medline, SCI, Embase, Cochrane Library, and Chinese Biomedicine Database were searched for studies published before January 1, 2009 that were randomized controlled trials for postoperative patients. Parenteral nutrition with or without fish oil emulsion was the only difference between the intervention and control groups. Methodologic quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 and Jadad's score scale. RevMan 5.0 statistical software was used for meta-analysis.
  
  
  RESULTS
  Six trials met all inclusion criteria and were enrolled for final meta-analysis. The aggregated results of the trails showed that fish oil was associated with no mortality advantage. There was a significant reduction in infectious complications in patients receiving fish oil (relative risk 0.49, 95% confidence interval 0.26-0.93, P=0.03). The result on length of hospital stay showed a trend of shortening by 3.06 d associated with receiving fish oil. However, the difference was not significant. When excluding one obviously heterogeneous study and aggregating the other three remaining studies, results showed significantly shortening of length of hospital stay associated with receiving fish oil. Fish oil also significantly shortened length of stay in the intensive care unit by 2.07 d.
  
  
  CONCLUSIONS
  The administration of lipid emulsion containing fish oil to patients undergoing elective major operations improves outcomes. The infectious complications are significantly fewer and length of hospitalization significantly shortened for patients treated with lipid emulsion containing fish oil. Further well-designed randomized controlled trials are needed to demonstrate the cost effectiveness of lipid emulsion containing fish oil to postoperative patients.
authors.affiliation: Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Beijing, People's Republic of China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wei
authors.forename: Jiang
authors.initials: J
authors.lastname: Hua
authors.forename: Cai
authors.initials: C
authors.lastname: Bin
authors.forename: Karen
authors.initials: K
authors.lastname: Klassen
mesh_terms: D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D005395:Fish Oils / Q000008:administration & dosage*; D006801:Humans; D007239:Infections; D007362:Intensive Care Units; D007902:Length of Stay; D016239:MEDLINE; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic
chemical_list: D005217:Fat Emulsions, Intravenous; D005395:Fish Oils