Sepsis affects 50 million people globally, contributing to 20% of all deaths and significantly increasing healthcare costs due to intensive care needs. Although the role of omega-3 fatty acids in reducing sepsis mortality remains debated, recent studies suggest their potential in modulating immune responses and improving outcomes. This umbrella review aims to clarify the benefits of omega-3 supplementation on mortality rate, length of ICU stays, and days on mechanical ventilation in patients with sepsis.
Following Cochrane and GRADE methodologies, a systematic search was conducted across multiple databases up to February 2025. After independent screening, data extraction, and critical appraisal, meta-analyses were reassessed using the DerSimonian and Laird model. Evidence was graded using the GRADE approach, categorizing outcomes based on strength and quality.
A comprehensive search identified 934 records, of which 34 RCTs from 21 systematic reviews and meta-analyses focused on omega-3 supplementation in sepsis patients. Omega-3 significantly reduced mortality (RR: 0.79, 95% CI: 0.69 to 0.90), length of ICU stays (MD: -3.6 days, 95% CI: -4.39 to -2.81), and ventilation days (MD: -2.86 days, 95% CI: -4.46 to -1.26). Parenteral nutrition showed slightly better outcomes than enteral nutrition, and EPA and DHA provided superior results compared to mixed oils.
These findings suggest omega-3 supplementation could improve mortality, ICU stays, and ventilator dependency in patients with sepsis. However, the certainty of the evidence ranges from low to very low, emphasizing the need for further high-quality RCTs to validate these benefits. Also, clinicians should prescribe omega-3 supplements cautiously in this regard.