Safety and Efficacy of Fish Oil–Enriched Parenteral Nutrition Regimen on Postoperative Patients Undergoing Major Abdominal Surgery

Background: To evaluate the safety and efficacy of a fish oil–enriched parenteral nutrition regimen in patients undergoing major abdominal surgery, a meta‐analysis of randomized controlled trials was conducted. Methods: An electronic search of PubMed, MEDLINE, EMBASE, Academic Search Premier, and China National Knowledge Infrastructure databases was performed in March 2009. RevMan 5.0 was used for statistical analysis. Results: The combined analysis showed that a fish oil–enriched parenteral nutrition regimen had a positive treatment effect on length of hospital stay (weighed mean difference = ?2.98, P < .001), length of intensive care unit stay, postoperative infection rate (odds ratio = 0.56, P = .04), and serum levels of aspartate aminotransferase, alanine aminotransferase, and α‐tocopherol on postoperative day 6 in these patients. The regimen increased the plasma levels of eicosapentaenoic acid (standardized mean difference = 3.11, P < .001) and docosahexaenoic acid and upregulated the leukotriene B₅ production in leukocytes on postoperative day 6. No significant differences were found between the 2 groups in postoperative mortality; incidence of postoperative cardiac complications; serum levels of bilirubin, triglyceride, or arachidonic acid; or the liberation of leukotriene B₄. No serious adverse events related to fish oil treatment were reported. Conclusions: Based on the meta‐analysis, fish oil–supplemented parenteral nutrition was safe, improved clinical outcomes, and altered the fatty acid pattern as well as leukotriene synthesis. More laboratory parameters should be considered in future meta‐analyses.