Abstract：
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.
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.
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.
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.
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.
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.
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.
摘要：
目的：严重烧伤导致代谢改变，全身炎症反应综合征，和多器官功能障碍综合征。Omege-3多不饱和脂肪酸(PUFA)具有抗炎性质。在没有大量证据证明用于严重烧伤的情况下，我们系统评价了omega-3PUFA对严重烧伤患者的疗效.
方法：我们全面搜索了MEDLINE，WebofScience,Embase,科克伦图书馆,中国全民知识互联网,王芳数据,中国生物医学数据库,和ScienceDirect数据库收集2000年1月至2023年6月烧伤患者服用omega-3PUFA的随机对照试验。两名研究人员独立筛选了这些文献，提取数据，并评估纳入研究的偏倚风险。结果是死亡率，严重败血症的风险,感染性休克,和多器官功能障碍综合征。使用ReviewManager进行数据合成。对结果进行试验序贯分析（TSA）。
结果：纳入了三项涉及140名患者的随机对照试验。其中,71例患者接受了omega-3PUFA。结果显示，omega-3PUFAs显著降低了严重脓毒症的发病率，感染性休克,多器官功能障碍综合征(RR=0.38，95%CI[0.19，0.75]，P=0.005),C反应蛋白水平（MD=-39.70[-81.63,2.23]，P=0.06),和改善呼吸结果。然而,14天死亡率无差异（RR=1.10,95CI[0.59,2.05]，P=0.75）。TSA结果显示严重脓毒症的发病率,感染性休克,多器官功能障碍综合征是不充分和不确定的。
结论：Omega-3PUFA可降低炎症反应和脓毒症风险，感染性休克,严重烧伤患者的多器官功能障碍综合征，可能缩短住院时间，但不能降低死亡风险。由于纳入研究的数量和质量的限制,证据水平很低，结论需要通过更大规模和更高质量的随机对照试验来验证。
方法：我们全面搜索了MEDLINE，WebofScience,Embase,科克伦图书馆,中国全民知识互联网,王芳数据,中国生物医学数据库,和ScienceDirect数据库收集2000年1月至2023年6月烧伤患者服用omega-3PUFA的随机对照试验。两名研究人员独立筛选了这些文献，提取数据，并评估纳入研究的偏倚风险。结果是死亡率，严重败血症的风险,感染性休克,和多器官功能障碍综合征。使用ReviewManager进行数据合成。对结果进行试验序贯分析（TSA）。
结果：纳入了三项涉及140名患者的随机对照试验。其中,71例患者接受了omega-3PUFA。结果显示，omega-3PUFAs显著降低了严重脓毒症的发病率，感染性休克,多器官功能障碍综合征(RR=0.38，95%CI[0.19，0.75]，P=0.005),C反应蛋白水平（MD=-39.70[-81.63,2.23]，P=0.06),和改善呼吸结果。然而,14天死亡率无差异（RR=1.10,95CI[0.59,2.05]，P=0.75）。TSA结果显示严重脓毒症的发病率,感染性休克,多器官功能障碍综合征是不充分和不确定的。
结论：Omega-3PUFA可降低炎症反应和脓毒症风险，感染性休克,严重烧伤患者的多器官功能障碍综合征，可能缩短住院时间，但不能降低死亡风险。由于纳入研究的数量和质量的限制,证据水平很低，结论需要通过更大规模和更高质量的随机对照试验来验证。
