Safety and efficacy of fish oil-enriched parenteral nutrition regimen on postoperative patients undergoing major abdominal surgery: a meta-analysis of randomized controlled trials.
BACKGROUND
To evaluate the safety and efficacy of a fish oil-enriched parenteral nutrition regimen in patients undergoing major abdominal surgery, a meta-analysis of randomized controlled trials was conducted.


METHODS
An electronic search of PubMed, MEDLINE, EMBASE, Academic Search Premier, and China National Knowledge Infrastructure databases was performed in March 2009. RevMan 5.0 was used for statistical analysis.


RESULTS
The combined analysis showed that a fish oil-enriched parenteral nutrition regimen had a positive treatment effect on length of hospital stay (weighed mean difference = -2.98, P < .001), length of intensive care unit stay, postoperative infection rate (odds ratio = 0.56, P = .04), and serum levels of aspartate aminotransferase, alanine aminotransferase, and alpha-tocopherol on postoperative day 6 in these patients. The regimen increased the plasma levels of eicosapentaenoic acid (standardized mean difference = 3.11, P < .001) and docosahexaenoic acid and upregulated the leukotriene B(5) production in leukocytes on postoperative day 6. No significant differences were found between the 2 groups in postoperative mortality; incidence of postoperative cardiac complications; serum levels of bilirubin, triglyceride, or arachidonic acid; or the liberation of leukotriene B(4). No serious adverse events related to fish oil treatment were reported.


CONCLUSIONS
Based on the meta-analysis, fish oil-supplemented parenteral nutrition was safe, improved clinical outcomes, and altered the fatty acid pattern as well as leukotriene synthesis. More laboratory parameters should be considered in future meta-analyses.
Chen
Bo
B
Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China.
Zhou
Yong
Y
Yang
Ping
P
Wan
Hong-wei
HW
Wu
Xiao-ting
XT
D000005:Abdomen / Q000601:surgery; D003422:Critical Care; D003428:Cross Infection / Q000097:blood / Q000276:immunology / Q000517:prevention & control*; D004041:Dietary Fats / Q000008:administration & dosage; D005217:Fat Emulsions, Intravenous; D005395:Fish Oils / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay; D007962:Leukocytes / Q000378:metabolism; D010288:Parenteral Nutrition / Q000379:methods*; D011183:Postoperative Complications / Q000097:blood / Q000276:immunology / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D024502:alpha-Tocopherol / Q000097:blood
D004041:Dietary Fats; D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D024502:alpha-Tocopherol