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

There are still debates regarding the impact of omega-3 fatty acids on immune response and clinical outcomes in critically ill patients. Explore the effects of omega-3 fatty acids on hyper-inflammatory response and clinical outcomes in critically ill patients. 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). 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. 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. 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.