Evidence map›Paper›PMID 37709313›Full record

SynthesisBMJ open2023

Does inclusion of bioactive n-3 PUFAs in parenteral nutrition benefit postoperative patients undergoing liver surgery? A systematic review and meta-analysis of randomised control trials.

Zheng-Wei He, Chao Wang, Yong Li, Awang Danzeng, Fu-Bin Liu, Jia-Yu Shi, Pingcuo Ciren, Xiao-Yin Yuan, Cheng-Xian Wu, Run-Hu Lan and 1 more

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

11 authors.

Zheng-Wei He *Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Chao Wang *Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.ORCID 0000-0001-5019-2379
Yong LiDivision of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, China.
Awang DanzengHepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Fu-Bin LiuDivision of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, China.
Jia-Yu ShiDivision of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, China.
Pingcuo CirenHepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Xiao-Yin YuanDivision of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, China.
Cheng-Xian WuDivision of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, China.
Run-Hu LanDivision of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, China.
Bin-Hao ZhangHepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China bhzhang8@163.com.ORCID 0000-0003-1983-3507

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis meta-analysis aims to evaluate the effect of n-3 polyunsaturated fatty acids (PUFAs) as a part of parenteral nutrition in patients undergoing liver surgery.

designSystematic review and meta-analysis. DATA SOURCES: PubMed, the Cochrane Central Register of Controlled Trials, Springer link, Web of Science, China National Knowledge Infrastructure and VIP Database. ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs) and evaluated the outcomes of liver function, inflammatory reaction, the influence of certain markers of the immune system, and specific clinical indexes for patients undergoing liver surgery and receiving parenteral nutrition with n-3 PUFAs. DATA EXTRACTION AND SYNTHESIS: The Cochrane Collaboration's tool was used to assess the risk of bias for each study. Findings were summarised in Grades of Recommendation, Assessment, Development and Evaluation evidence profiles and synthesised qualitatively.

resultsEight RCTs, including 748 patients (trial: 374; control: 374), were included in the meta-analysis. Compared with patients in the control group, the patients in the n-3 PUFA group who underwent liver surgery had significantly lower aspartate aminotransferase (mean difference, MD -42.72 (95% CI -71.91 to -13.52); p=0.004), alanine aminotransferase (MD -38.90 (95% CI -65.44 to -12.37); p=0.004), white cell count (MD -0.93 (95% CI -1.60 to -0.26); p=0.007) and IL-6 (MD -11.37 (95% CI -14.62 to -8.13); p<0.00001) levels and a higher albumin level (MD 0.42 (95% CI 0.26 to 0.57); p<0.00001). They also had fewer infection complications (OR 0.44 (95% CI 0.28 to 0.68); p=0.0003) and a shorter duration of hospital stay (MD -2.17 (95% CI -3.04 to -1.3); p<0.00001) than the controls. However, there were no significant differences in terms of total bilirubin, TNF-α, IL-2, IgA, IgG, IgM and CD3, biliary leakage and mortality between the two groups.

conclusionsWe found that n-3 PUFAs can benefit patients undergoing liver surgery by improving liver function and certain clinical indexes and decreasing related inflammation factors. However, there are limited RCTs on the application of n-3 PUFAs for patients undergoing liver surgery. Further evidence of the benefit of n-3 PUFAs in these patients warrants further exploration.

Indexed as

Fatty Acids, Omega-3Fatty Acids, UnsaturatedHumansInflammationLiverParenteral NutritionFatty Acids, Omega-3Fatty Acids, Unsaturatedhepatobiliary surgerynutritionnutritional supportsurgery

Identifiers

PMID37709313
PMCPMC10503353

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.