Effects of omega-3 fatty acids on hyper-inflammatory response and clinical outcomes in critically ill patients: a meta-analysis

BACKGROUND: There are still debates regarding the impact of omega-3 fatty acids on immune response and clinical outcomes in critically ill patients. OBJECTIVE: Explore the effects of omega-3 fatty acids on hyper-inflammatory response and clinical outcomes in critically ill patients. METHODS: We searched five databases from inception to July 18, 2024 and collected randomized controlled trials in which critically ill patients treated in an intensive care unit (ICU) were administered omega-3 fatty acids as a supplement. Data were expressed as mean difference, standard mean difference, or odds ratio with 95% confidence interval (CI). RESULTS: There were 41 randomized controlled trials that met the inclusion criteria, and they involved 3152 patients. The intervention with omega-3 fatty acids significantly reduced the following biomarkers: white blood cell count on day 3 and day 6/7, tumor necrosis factor-α (TNF-α) on day 3 and day 5, interleukin-1 (IL-1), interleukin-6 (IL-6), and procalcitonin at the last observation post-intervention. The intervention also reduced the Sequential Organ Failure Assessment (SOFA) score on day 5 and lowered the risk of secondary infections and new sepsis/septic shock, both determined during follow-up. It also significantly shortened the ICU stay and reduced the 28-day mortality rate, although ICU mortality rate remained unchanged. CONCLUSIONS: Omega-3 fatty acids supplementation may be effective in modulating hyper-inflammatory responses, reducing the risk of complications and disease severity, and improving clinical outcomes. IMPLICATIONS FOR CLINICAL PRACTICE: Omega-3 fatty acids may serve as a potential nutritional therapy for critically ill patients, when medical staff identify the hyperinflammatory status of patients based on medical history, clinical manifestations, and laboratory results.