Omega-3 Supplementation in CABG Patients: Impact on ICU Stay, and Hospital Stay (A Systematic Review And Meta-Analysis)

Abstract

Background: Coronary artery bypass graft surgery is a major surgery that can lead to inflammation and complications, including increased length of ICU stay and length of hospitalization. Omega-3 PUFA has anti-inflammatory properties, and it has been hypothesized that it may reduce these complications in CABG patients. Objectives: To conduct a systematic review and meta-analysis on the effect of perioperative omega 3 PUFA supplementation on total ICU stay and total hospital stay in CABG patients. Methods: Randomized controlled trials were included if they studied the effect of omega-3 PUFA supplementation (oral or intravenous) on ICU stay and length of hospitalization in CABG patients. Studies were searched for in Medline (PubMed), EMBASE, PsychINFO, CINAHL, and the Cochrane Central Register of Controlled Trial databases along with hand searching of reference lists. The quality and risk of bias of the included studies were evaluated by two independent reviewers using the revised Cochrane risk-of-bias tool. Meta-analysis was performed using fixed or random effect models according to the level of heterogeneity by mean difference with their 95% confidence intervals. Results: Twelve studies were included in the qualitative analysis and 7 studies were included in meta-analysis. No statistical difference was observed between the omega 3 PUFA and control groups regarding ICU stay MD -0.25 (95% CI -0.68, 0.17). Omega-3 PUFA was associated with a significant reduction in days of hospital stay -0.58 (95% CI -1.13, -0.04). Subgroup analysis showed that only oral omega 3 PUFA supplementation resulted in a statistically significant reduction in length of hospitalization after subgroup analysis with MD -0.6 (95% CI -1.17, -0.04). Conclusion: This systematic review and meta-analysis suggests that perioperative omega-3 PUFA supplementation may reduce the length of hospitalization in CABG patients, especially when administered orally. However, the findings should be interpreted cautiously due to the high level of heterogeneity and the presence of concerns regarding the internal quality and external validity of the included studies.