Parenteral Nutrition Containing Fish Oil for Hospitalized Non-Intensive Care Unit (ICU) Patients: A Systematic...

Area of Science:

• Clinical Nutrition
• Medical Economics
• Evidence-Based Medicine

Background:

• Parenteral nutrition (PN) is crucial for hospitalized patients unable to receive adequate oral intake.
• Fish oil-enriched parenteral nutrition (FO-PN) is a specialized formulation with potential clinical benefits.
• Standard PN (NF-PN) lacks fish oil supplementation.

Purpose of the Study:

• To compare the efficacy and cost-effectiveness of FO-PN versus NF-PN in adult patients on general hospital wards.
• To evaluate the impact of FO-PN on infection rates, hospital length of stay, and mortality.
• To assess the economic implications of FO-PN across different healthcare systems.

Main Methods:

• Systematic literature search of Medline, Embase, and Web of Science up to October 2024.
• Inclusion of 29 randomized controlled trials (RCTs) comparing FO-PN and NF-PN.
• Meta-analysis using random effects models, with subgroup analyses and meta-regression for heterogeneity exploration.

Main Results:

• FO-PN significantly reduced the relative risk of infection by 37% (RR 0.63, p < 0.0001) and sepsis by 51% (RR 0.49, p = 0.0009).
• Hospital length of stay was reduced by 2.03 days with FO-PN (p < 0.00001).
• A non-significant trend towards reduced 30-day mortality was observed with FO-PN (RR 0.46, p = 0.07).

Conclusions:

• FO-PN demonstrates superior clinical outcomes, including reduced infection and shorter hospital stays, compared to NF-PN.
• FO-PN represents a cost-effective nutritional strategy for adult patients in general hospital settings.
• The findings support the integration of FO-PN into standard care for eligible hospitalized patients.