Omega-3 Fatty Acids Supplementation Improves Pulmonary Function and Clinical Outcomes in Critically Ill Patients: a...

Although several studies have examined the relationship between omega-3 (ω-3) fatty acids and pulmonary function and clinical outcomes in critically ill patients, their findings remain mixed and inconclusive, and additional research is warranted.

This study aimed to evaluate the effects of ω-3 fatty acids on pulmonary function and clinical outcomes in critically ill patients.

We searched 5 databases (PubMed, Web of Science, Embase, EBSCO, and Cochrane Central Register of Controlled Trials) to identify randomized controlled trials involving critically ill adults who received ω-3 fatty acids. Both enteral and parenteral routes of administration were included. Effect estimates were pooled using fixed- or random-effects models, and heterogeneity among studies was assessed using the I² statistic.

The analysis included 29 studies involving 2551 critically ill patients. The ω-3 fatty acids intervention significantly increased EPA and DHA levels. For inflammatory and immune markers, it increased CD4⁺ T lymphocytes, the CD4⁺/CD8⁺ ratio, and decreased C-reactive protein (CRP) levels. For pulmonary function, it increased PaO₂, SaO₂, and PaO₂/FiO₂, and decreased airway resistance, positive end expiratory pressure, and lactate levels. For clinical outcomes, it significantly shortened mechanical ventilation days [mean difference: -1.31; 95% confidence interval (CI): -2.54, -0.09; P = 0.04] and length of hospitalization (mean difference: -3.96; 95% CI: -7.83, -0.09; P = 0.04). Both enteral and parenteral supplementation with ω-3 could reduce CRP levels, shorten hospital stay, and improve the oxygenation index. Besides, ω-3 via enteral nutrition also increases PaO₂ and shortens mechanical ventilation days.

In critically ill patients, ω-3 fatty acids may improve fatty acid concentrations, modulate immune regulation, enhance pulmonary function, and be associated with improved clinical outcomes.