PP115 - COMPARATIVE ANALYSIS OF FISH OIL (FO)-DERIVED OMEGA-3 FATTY ACID ENRICHED PARENTERAL NUTRITION REGIMENS VERSUS STANDARD NON-FO-ENRICHED PARENTERAL NUTRITION REGIMENS IN HOSPITALIZED PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS.
PP115
COMPARATIVE ANALYSIS OF FISH OIL (FO)-DERIVED OMEGA-3 FATTY ACID ENRICHED PARENTERAL NUTRITION REGIMENS VERSUS STANDARD NON-FO-ENRICHED PARENTERAL NUTRITION REGIMENS IN HOSPITALIZED PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS.
P. Singer1,*, S. Krenberger2, J. Jost2, S. Walzer2,3, P. C. Calder4
1ICU, Institute for Nutrition Research, Department of Intensive Care Medicine, Rabin Medical Center, Beilinson Hospital, Petah Tikva, and Herzlia Medical Center, Dina Recanati Medical School, Reichman University, , Herzliya, Israel, 2MArS Market Access & Pricing Strategy GmbH, Weill am Rhein, 3State University Baden-Wuerttemberg, Loerrach, Germany and University of Applied Sciences Ravensburg-Weingarten, , Weingarten,, Germany, 4Biomedical Research Centre, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom g NIHR Southampton , University Hospital Southampton NHS Foundation Trust and University of Southampton, , Southampton, United Kingdom
Rationale: This systematic literature review (SLR) and meta-analysis (MA) compares clinical efficacy and safety of FO-enriched lipid emulsions (ILEs) to standard non-FO-enriched ILEs in hospitalized patients receiving parenteral nutrition (PN), extending previous findings.
Methods: MEDLINE, EMBASE, and CENTRAL identify randomized controlled trials in hospitalized adults for inclusion in the SLR. Random effects MA was performed when feasible. Key outcomes to be analyzed included mortality, length of stay (LOS) in hospital and ICU, and infection rates. Pre-defined covariates were patient categorization (surgical or ICU), total PN duration, daily FO and lipid dosage.
Results: 51 studies (4163 patients) were included, comprising a heterogeneous ICU and surgical patient population. 33 studies (2696 patients) compared FO as an add-on vs. standard PN, and 9 studies each (749 and 718 patients) compared one of two mixed ILEs vs. standard PN. FO as an add-on showed the strongest effect across endpoints, including significant (p<0.03) reductions in mortality (odds ratio [OR] 0.58 [0.39, 0.86]; p = 0.006), LOS hospital, infection rate, and abdominal infection rate. For the comparison, fish oil + soy oil + medium-chain triglycerides (FSM) vs. standard PN, the strongest effects were obtained for infection rate (OR 0.48 [0.27, 0.84]; p 0.01), hospital LOS, and ICU LOS (p < 0.03) while no significant effects were obtained for FSM + olive oil (FSMO). The study risk of bias was low to moderate.
Conclusion: With FO (add-on) or with FSM, consistent reductions in infections, ICU, and/or hospital LOS were observed; FO as an add-on additionally reduced mortality. These findings underline the clinical relevance of FO-enriched PN.
Disclosure of Interest: P. Singer Grant / Research Support from: Grant from Nestle, Fresenius Kabi, ART MEDICAL, Consultant for: ART MEDICAL, Speakers Bureau of: Baxter, Nestle, Fresenius Kabi, S. Krenberger: None declared, J. Jost: None declared, S. Walzer: None declared, P. Calder Consultant for: ah hoc consultant/advisor to Danone Nutricia Research, dsm-firmenich, Fresenius-Kabi, B. Braun Melsungen, Nestle, Baxter Healthcare and Abbot Nutrition, Speakers Bureau of: dsm-firmenich, Fresenius-Kabi, Abbott Nutrition