Science Update: Omega-3 PUFAs and the Treatment of SIRS

tituloAs recently published by GOED in April 22, results from a meta analysis [1] published in April 2015 by Wan et al, for individuals with systemic inflammatory response syndrome (SIRS), omega-3 supplementation reduces the risk of death by a remarkable 23%, and reduces hospital stays by an average of 10 days.

SIRS is a serious acute condition, related to sepsis, characterized by systemic inflammation and organ dysfunction and failure. It is caused by an immune response to either an infectious or non-infectious insult. New and better therapies are being developed and SIRS is a focus of active research, but it remains a major cause of mortality in critically ill patients [2]. Based on follow-ups of hospital patients, it is estimated that mortality caused by SIRS is approximately 6%, and that 28% of patients with SIRS will develop sepsis [3].

Because of their well-known anti-inflammatory properties, omega-3 PUFAs are commonly used in the treatment of SIRS and related conditions. The European Society for Parenteral and Enteral Nutrition (ESPEN) guidelines recommend the use of fish oil in critical patients, including those suffering from SIRS [4].

This study showcases clearly the importance of the meta analyses form of scientific research. One of the limitations of RCTs is that it is often impossible to examine a sufficient number of patients. Because a meta analysis uses statistical techniques to combine the results of several existing studies, the strength of meta analyses is that they can aggregate a number of subjects that would be impossible to have in an RCT. In the case of Wan et al, nine RCTs were identified with 783 combined participants, while the largest RCT identified only enrolled 181 subjects. This larger number of patients allows the researchers to make more accurate estimates of the effect of supplementation.

Like all kinds of studies, meta analyses have their drawbacks, so their results need to be evaluated with the same care as those of other studies, including RCTs. But if meta analyses are well designed and properly executed — as is the case with this article — and the purely numerical results are interpreted in light of prior knowledge on the subject, then it is an essential tool for modern biomedical research.

The results presented confirm that the recommendation to use EPA- and DHA-rich fish oils as part of the treatment of patients with SIRS is not only based on a solid biochemical basis, but does, in fact, result in better outcomes, shorter hospital stays,  and a much reduced mortality rate.

  1. Wan X, Gao X, Bi J, Tian F, Wang X. Use of n-3 PUFAs can decrease the mortality in patients with systemic inflammatory response syndrome: a systematic review and meta-analysis. Lipids Health Dis. 2015;14(1):23.
  2. Angus DC, Van der poll T. Severe sepsis and septic shock. N Engl J Med. 2013;369(21):2063.
  3. Pittet D, Rangel-frausto S, Li N, et al. Systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock: incidence, morbidities and outcomes in surgical ICU patients. Intensive Care Med. 1995;21(4):302-9.
  4. Singer P, Berger MM, Van den Berghe G, Biolo G, Calder P, Forbes A, et al. ESPEN guidelines on parenteral nutrition: intensive care. Clin Nutr.2009;28:387–400.
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Dimitri Sclabos

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