{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:07:21Z","timestamp":1793412441728,"version":"4.5.0"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T00:00:00Z","timestamp":1604361600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T00:00:00Z","timestamp":1604361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fresenius Kabi"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Omega-3 (\u03c9-3) fatty acid (FA)-containing parenteral nutrition (PN) is associated with significant improvements in patient outcomes compared with standard PN regimens without \u03c9-3 FA lipid emulsions. Here, we evaluate the impact of \u03c9-3 FA-containing PN versus standard PN on clinical outcomes and costs in adult intensive care unit (ICU) patients using a meta-analysis and subsequent cost-effectiveness analysis from the perspective of a hospital operating in five European countries (France, Germany, Italy, Spain, UK) and the US.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We present a pharmacoeconomic simulation based on a systematic literature review with meta-analysis. Clinical outcomes and costs comparing \u03c9-3 FA-containing PN with standard PN were evaluated in adult ICU patients eligible to receive PN covering at least 70% of their total energy requirements and in the subgroup of critically ill ICU patients (mean ICU stay\u2009&gt;\u200948\u00a0h). The meta-analysis with the co-primary outcomes of infection rate and mortality rate was based on randomized controlled trial data retrieved via a systematic literature review; resulting efficacy data were subsequently employed in country-specific cost-effectiveness analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In adult ICU patients, \u03c9-3 FA-containing PN versus standard PN was associated with significant reductions in the relative risk (RR) of infection (RR 0.62; 95% CI 0.45,\u00a00.86;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), hospital length of stay (HLOS) (\u2212\u20093.05\u00a0days; 95%\u00a0CI \u2212\u20095.03,\u00a0\u2212\u20091.07;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and ICU length of stay (LOS) (\u2212\u20091.89\u00a0days; 95%\u00a0CI \u2212\u20093.33,\u00a0\u2212\u20090.45;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). In critically ill ICU patients, \u03c9-3 FA-containing PN was associated with similar reductions in infection rates (RR\u00a00.65; 95%\u00a0CI 0.46,\u00a00.94;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), HLOS (\u2212\u20093.98\u00a0days; 95%\u00a0CI \u2212\u20096.90,\u00a0\u2212\u20091.06;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) and ICU LOS (\u2212\u20092.14\u00a0days; 95%\u00a0CI \u2212\u20093.89,\u00a0\u2212\u20090.40;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Overall hospital episode costs were reduced in all six countries using \u03c9-3 FA-containing PN compared to standard PN, ranging from \u20ac-3156\u2009\u00b1\u20091404 in Spain to \u20ac-9586\u2009\u00b1\u20094157 in the US.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These analyses demonstrate that \u03c9-3 FA-containing PN is associated with statistically and clinically significant improvement in patient outcomes. Its use is also predicted to yield cost savings compared to standard PN, rendering \u03c9-3 FA-containing PN an attractive cost-saving alternative across different health care systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study registration<\/jats:title>\n                    <jats:p>PROSPERO CRD42019129311.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13054-020-03356-w","type":"journal-article","created":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T07:03:09Z","timestamp":1604386989000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":68,"title":["Omega-3 fatty acid-containing parenteral nutrition in ICU patients: systematic review with meta-analysis and cost-effectiveness analysis"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7648-8917","authenticated-orcid":false,"given":"Lorenzo","family":"Pradelli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanislaw","family":"Klek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Jabbar","family":"Omar Alsaleh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin D.","family":"Rosenthal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel R.","family":"Heller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Muscaritoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,3]]},"reference":[{"issue":"1","key":"3356_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.clnu.2017.08.032","volume":"37","author":"PC Calder","year":"2018","unstructured":"Calder PC, Adolph M, Deutz NE, Grau T, Innes JK, Klek S, et al. 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Stanislaw Klek: Speakers honoraria: Baxter, Braun, Fresenius, Nestle, Nutricia. Konstantin Mayer: Fees from Abbott, AstellasZeneca, Baxter, BBraun, Fresenius Kabi, MSD, Nestle, Novartis, Pfizer. Abdul Jabbar Omar Alsaleh: No conflicts of interest. Martin D Rosenthal: No conflicts of interest. Axel R Heller: Project funding by Fresenius-Kabi and speaker honoraria by CSL- Behring. Maurizio Muscaritoli: No conflicts of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"634"}}