Evidence map›Paper›PMID 23609773›Full record

SynthesisJPEN. Journal of parenteral and enteral nutrition2014

Parenteral fish oil lipid emulsions in the critically ill: a systematic review and meta-analysis.

William Manzanares, Rupinder Dhaliwal, Brian Jurewitsch, Renee D Stapleton, Khursheed N Jeejeebhoy, Daren K Heyland

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in JPEN. Journal of parenteral and enteral nutrition, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01146821 (Multi-centre, Open-label, Phase II Clinical Trial for Determination of the Optimal Dose of Fish Oil in Patients With Severe Sepsis), which is not on this map. Cited by 29 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 6 pooled it
10.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01146821 phase2terminatednot on this map

Multi-centre, Open-label, Phase II Clinical Trial for Determination of the Optimal Dose of Fish Oil in Patients With Severe Sepsis

TypeinterventionalSponsorUniversity Hospital Carl Gustav CarusRan2013 to 2017Enrolled7ConditionsSepsisArms0.20 gm/kg fish oil, 0.50 gm/kg fish oil
3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 6 syntheses or guidelines pooled it, 93 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 6 institutions in 3 countries.

William ManzanaresDepartment of Critical Care Medicine, Faculty of Medicine, Universidad de la República (UDELAR), Montevideo, Uruguay.
Rupinder Dhaliwal
Brian Jurewitsch
Renee D Stapleton
Khursheed N Jeejeebhoy
Daren K Heyland
Kingston General Hospital · CAQueen's University · CASt. Michael's Hospital · CAUniversidad de la República · UYUniversity of Toronto · CAUniversity of Vermont · US

Funding

WEIGHT LOSS & ASTHMAP20RR015557 · NCRR · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI IRVIN, CHARLES G · 2000 to 2009
$21.4M
Pharmaconutrients as Therapies for Critical Illness: Zinc in Severe SepsisK23HL105654 · NHLBI · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI STAPLETON, RENEE D · 2011 to 2014
$626k
NCRR NIH HHS P20 RR015557NHLBI NIH HHS K23 HL105654
6 · The paper itself

Abstract

introductionω-3 Polyunsaturated fatty acids contained in fish oils (FO) possess major anti-inflammatory, antioxidant, and immunologic properties that could be beneficial during critical illness. We hypothesized that parenteral FO-containing emulsions may improve clinical outcomes in the critically ill.

methodsWe searched computerized databases from 1980-2012. We included randomized controlled trials (RCTs) conducted in critically ill adult patients that evaluated FO-containing emulsions, either in the context of parenteral nutrition (PN) or enteral nutrition (EN).

resultsA total of 6 RCTs (n = 390 patients) were included; the mean methodological score of all trials was 10 (range, 6-13). When the results of these studies were aggregated, FO-containing emulsions were associated with a trend toward a reduction in mortality (risk ratio [RR], 0.71; 95% confidence interval [CI], 0.49-1.04; P = .08; heterogeneity I (2) = 0%) and a reduction in the duration of mechanical ventilation (weighted mean difference in days [WMD], -1.41; 95% CI, -3.43 to 0.61; P = .17). However, this strategy had no effect on infections (RR, 0.76; 95% CI, 0.42-1.36; P = .35) and intensive care unit length of stay (WMD, -0.46; 95% CI, -4.87 to 3.95; P = .84, heterogeneity I (2) = 75%).

conclusionFO-containing lipid emulsions may be able to decrease mortality and ventilation days in the critically ill. However, because of the paucity of clinical data, there is inadequate evidence to recommend the routine use of parenteral FO. Large, rigorously designed RCTs are required to elucidate the efficacy of parenteral FO in the critically ill.

Indexed as

Critical IllnessEmulsionsEnteral NutritionFatty Acids, Omega-3Fish OilsHumansIntensive Care UnitsLength of StayParenteral NutritionRandomized Controlled Trials as TopicEmulsionsFatty Acids, Omega-3Fish Oilscritically illfish oilslipid emulsionsmeta-analyses

Identifiers

PMID23609773
PMCPMC4464759
OpenAlexW2059248685

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.