| Objective To evaluate the effectiveness and safety of omega-3Fatty Acidsin patients with acute lung injury/acute respiratory distress syndrome.Methods We searched for The Cochrane Library, Medical LiteratureAnalysis and Retrieval System Online (MEDLINE), Excerpta MedicaDatabase (EMBASE), Chinese Biomedical Database (CBM),Wan fang Dataand China National Knowledge Infrastructure (CNKI), and the date waslimited to December2013. Only randomized controlled trials (RCT) wereextracted and evaluated by two reviewers independently of each other. Themeta-analysis was performed by RevMan5.2software from CochraneCollaboration. Language was restricted to Chinese and English. A P value of<0.05was considered statistically significant.Results15randomized controlled studies (n=832patients, The experimental group of415cases. The control group417cases) were includedin this mete-analysis. Combined the analysis results show: with omega-3fattyacids, can reduce the28-day mortality for patients with ALI/ARDS［OR0.58,95%CI (0.40,0.85), P=0.005］; Bring down the mechanical ventilation time［WMD-1.33,95%CI (-1.73,-0.92), P﹤0.00001］;Improve oxygenationindex ［WMD23.27,95%CI (17.11,29.43), P﹤0.00001］; Get down theALI/ARDS patients’APACHEII score value［WMD-3.15,95%CI (-4.46,-1.84), P﹤0.00001］. Lower CRP levels ［WMD-11.54,95%CI (-15.46,-7.62), P﹤0.00001］; Reduce the level of TNF alpha ［WMD-53.58,95%CI(-85.41,-21.74), P=0.001］; Lower levels of ALI/ARDS IL-6［WMD-36.25,95%CI (-43.53,-28.98), P﹤0.00001］; There was no statisticallysignificant difference IL-10［WMD18.27,95%CI (-8.57，45.12), P=0.18］; There was no statistically significant difference ALB［WMD1.11,95%CI (0.46，2.67), P=0.16］. By subgroup analysis further revealed: use ofparenteral omega-3PUFA can improve the nutritional status［WMD3.19,95%CI (2.15,4.23), P﹤0.00001］. Adverse reactions was preformeddescriptive analysis only, there is no significant evidence shows that use ofomega-3fatty acids can increase the adverse reactions of patient withAIL/ARDS.Conclusions Based on the current studies, Compared with conventionaltreatment, use of omega-3fatty acids can adjust inflammatory mediators and improve Clinical symptoms and the outcome, but no find obvious adversereactions. The limitative factor of the quality and the sample, as well as risk ofbias, may affect the strength of the evaluation results evidence. We expecthigher quality, larger-scale randomized controlled clinical research will bemade, and which would be verified the truth. |
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