Nutritional Support with Omega-3 Fatty Acids in Burn Patients: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

Long-chain polyunsaturated fatty acids supplementation and sepsis: a systematic review and meta-analysis

BACKGROUND

Long chain polyunsaturated fatty acids (LCPUFAs) have proven to be essential for development in preterm infants and have been studied for their capacity to reduce inflammation and infection rates, including sepsis in enteral and parenteral nutrition. The aim of this review and meta-analysis is to gather the information available on this subject to determine if n-3 polyunsaturated fatty acids can reduce sepsis incidence in preterm infants.

METHODS

This systematic review was conducted by searching in the databases MEDLINE (via PubMed), ISI-Web of Science, EMBASE, SCOPUS, SciELO, and Cochrane Library databases. We analyzed the data regarding sepsis using the Grading of Recommendations Assessment, Development and Evaluation approach to assess the quality of the evidence.

RESULTS

A total of 40 trials were included for review and 35 trials had the data available for quantitative analysis. LCPUFAs supplementation did not reduce incidence of sepsis (relative risk (RR), confidence interval (CI) 0.95 [0.87, 1.03] P = 0.87; I2 = 0%). These results remained consistent after the sensitivity analysis.

CONCLUSION

The results of this systematic review and meta-analysis indicate that LCPUFA supplementation is not associated with a significant decrease in the incidence of sepsis in premature infants.

IMPACT

Reviewing the information available about LCPUFA supplementation and sepsis since the results in previous Clinical Trials (CT) are inconclusive. It summarizes the results of 42 CT and we have not found conclusive results regarding sepsis in the literature. It could be of clinical interest for pediatricians and nutritionists.

The efficacy of Omega-3 polyunsaturated fatty acids for severe burn patients: A systematic review and trial sequential meta-analysis of randomized controlled trials

BACKGROUND & AIMS

Severe burns lead to metabolic changes, systemic inflammatory response syndrome, and multiple organ dysfunction syndrome. Omege-3 polyunsaturated fatty acids (PUFAs) have anti-inflammatory properties. In the absence of substantial evidence for use on major burns, we systematically reviewed the efficacy of omega-3 PUFAs for patients with severe burns.

METHODS

We comprehensively searched MEDLINE, Web of Science, Embase, Cochrane Library, China National Knowledge Internet, Wang Fang Data, Chinese Biomedicine Database, and Science Direct databases to collect randomised controlled trials of omega-3 PUFAs administered to patients with burns from January 2000 to June 2023. Two researchers independently screened the literatures, extracted the data, and assessed the risk of bias in the included studies. The outcomes were mortality, the risk of severe sepsis, septic shock, and multiple organ dysfunction syndrome. Data synthesis was conducted using Review Manager. Trial sequential analyses (TSA) for outcomes were performed.

RESULTS

Three randomised controlled trials involving 140 patients were included. Of these, 71 patients received omega-3 PUFAs. The results showed that omega-3 PUFAs significantly reduced the incidence of severe sepsis, septic shock, multiple organ dysfunction syndrome (RR = 0.38, 95 % CI [0.19, 0.75], P = 0.005), C-reactive protein levels (MD = -39.70[-81.63, 2.23], P = 0.06), and improved respiratory outcomes. However, there was no difference in 14-day mortality (RR = 1.10, 95%CI [0.59, 2.05], P = 0.75). TSA showed that the results for the incidence of severe sepsis, septic shock, multiple organ dysfunction syndrome are insufficient and inconclusive.

CONCLUSIONS

Omega-3 PUFAs may reduce inflammatory response and risk of sepsis, septic shock, and multiple organ dysfunction syndrome in severe burns patients and may shorten hospital stay but cannot reduce risk of death. Due to the limitation of the quantity and quality of the included studies, the evidence level is low, and the conclusions need to be verified by larger scale and higher quality randomised controlled trials.

Effect of Yak Meat to the Daily Ration of Scalded Rats for Wound Healing

Objective

Treatment of burn wound healing involves infection, nutrition, psychology and rehabilitation, and proper nutritional support can promote wound healing, enhance immune function and reduce the incidence of complications. This study aimed to investigate the effects of feed containing yak meat on scalded rats' body condition and wound healing.

Methods

Adopting a two-factor factorial design, the growth performance, food intake, body weight, and Lee's index of rats were measured. The wound conditions of scalded rats with different feeds (basic, basic + yak meat, and basic + yellow beef) were observed at different periods, and their wounds' hematoxylin and eosin (H&E) staining states were detected. The proliferating cell nuclear antigen (PCNA)-positive cells and apoptosis were analyzed to evaluate the effects of feed on the wound healing of scalded rats.

Results

The feed intake was the highest in the yellow beef feed group and the lowest in the yak meat feed group. The body weight was the highest in the yak meat feed group and the lowest in the yellow beef feed group. Furthermore, 45 days after scalding, the obesity index in the yak beef feed group was the closest to that of the rats before scalding. The wound recovery of the rats in the yak meat feed group was the best at 30 days, and the H&E staining results also proved that the recovery effect of the scalded rats in the yak meat feed group was better than other two groups. According to the results of PCNA and apoptosis, the yak meat feed group had lower positive cell rate and faster wound healing.

Conclusion

The rats in the yak meat feed group recovered better than those in the other groups, and the yak beef feed had the best effect on the wound healing of the scalded rats.