Review Article

The Role of Omega-3 Polyunsaturated Fatty Acids in the Treatment of Patients with Acute Respiratory Distress Syndrome: A Clinical Review

Table 2

Omega-3 polyunsaturated fatty acids in ARDS.

Author/yearDesignInterventionMain outcomes

Masclans et al., 1998 [32]RCT, single-centre21LCT/MCT (versus LCT versus placebo),
12 hr
↑CO, O2 consumption and delivery
=  Pulmonary haemodynamics and arterial O2 tension

Suchner et al., 2001 [33]RCT (crossover)18Rapid (6 hr) versus slow (24 hr) fat emulsion,
LCT/MCT
Rapid: ↑P/T, pulmonary shunt and CO; ↓PVR, SVR, and PaO2/FIO2

Faucher et al., 2003 [34]RCT (crossover)18LCT/MCT (versus LCT),
6 hr
Transitory ↑PaO2/FIO2

Gadek et al., 1999 [36]RCT, multicentre146EPA + GLA, 4–7 days↑PaO2/FIO2
↓Days of MV and UCI LOS

Sabater et al., 2008 [37]RCT, single-centre16LCT/MCT/ω-3 (versus LCT),
12 hr
=  Oxygenation, haemodynamics

Sabater et al., 2011 [38]RCT, single-centre16LCT/MCT/ω-3 (versus LCT),
12 hr
↓LTB4, TXB2, 6-keto-PG during infusion

Singer et al., 2006 [39]RCT, single-centre100EPA + GLA (versus standard), 14 daysTransitory ↑PaO2/FIO2
=  Mortality

Pontes-Arruda et al., 2011 [40]RCT, multicentre115EPA + GLA (versus standard),
7 days
↓Severe sepsis and SS
↓Cardiac and respiratory failure
↓Days of MV and UCI LOS
=  28-day mortality

Rice et al., 2011 [41]RCT, multicentre272EPA + GLA supplementation (versus standard) twice daily↓MV-free days, ICU-free days, nonpulmonary organ failure-free days
Stopped for futility

Stapleton et al., 2011 [42]RCT, multicentre90EPA + DHA (versus placebo),
14 days
↑Serum EPA
=  IL-8 in BALF, organ failure score, MV-free days, ICU-free days, and 60-day mortality

Grau-Carmona et al., 2011 [43]RCT, multicentre132EPA + GLA (versus standard)=  Oxygenation and organ failures

Elamin et al., 2012 [44]RCT, multicentre17EPA + GLA (versus standard),
7 days
↓LIS, ICU LOS, 28-day multiorgan dysfunction score
=  Mortality

RCT: randomized controlled trial; LCT: long-chain triglycerides; MCT: medium-chain triglycerides; CO: cardiac output; EPA: eicosapentaenoic acid; GLA: gamma-linolenic acid; PaO2/FIO2: partial pressure of arterial oxygen/fraction of inspired oxygen; MV: mechanical ventilation; ICU LOS: intensive care unit length of stay; P/T: prostaglandin I2/thromboxane A2 ratio; PVR: pulmonary vascular resistance; SVR: systemic vascular resistance; LTB4: leukotriene B4; TXB2: thromboxane B2; 6-keto-PG: 6-keto-prostaglandin; IL-8: interleukin 8; BALF: bronchoalveolar lavage fluid; LIS: lung injury score.