What happened to total parenteral nutrition? The disappearance of its use in a trauma intensive care unit

The Journal of Trauma
Peter RheeDemetrios Demetriades

Abstract

Total parenteral nutrition (TPN) is associated with known costs, including the use of invasive procedures, which may be necessary to optimize care. Our purpose was to document TPN use in trauma patients over time as well as concurrent changes in TPN-associated complications. Retrospective analysis of all consecutive trauma patients admitted to the surgical intensive care unit during a period of 6 years from a Level I trauma center. Comparative cohorts and the matched case-control approaches were used to analyze the difference in outcomes between patients with and without TPN during hospitalization. Logistic regression model was used to compare the outcomes of the two groups of patients adjusting for significant risk factors. The McNemar's test was used to assess the differences in outcomes between the cases and their matched controls. There were 2,964 patients admitted to the surgical intensive care unit during the 6-year period and 464 patients received TPN during their hospital course. TPN use decreased significantly from 26% in the year 2000 to 3% in 2005 (p < 0.0001). Excluding those who died in the first 72 hours, the mortality rate was significantly lower (5.4% no TPN vs. 10.2% TPN, p = 0.001) in patients who were managed...Continue Reading

References

Aug 22, 1991·The New England Journal of Medicine·UNKNOWN Veterans Affairs Total Parenteral Nutrition Cooperative Study Group
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Aug 30, 2005·Journal of the American College of Surgeons·Demetrios DemetriadesLinda Chan
Nov 23, 2006·The Surgical Clinics of North America·Juan B Ochoa, David Caba

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Citations

Jun 16, 2010·Current Gastroenterology Reports·Keith R Miller, Stephen A McClave
Sep 11, 2009·The New England Journal of Medicine·Thomas R Ziegler
Oct 2, 2009·Surgical Infections·Stephen F Lowry
Sep 23, 2014·American Journal of Surgery·Usama Ahmed AliRavi P Kiran
Apr 25, 2013·The Journal of Surgical Research·Kazuhide MatsushimaMatthew C Indeck
Nov 16, 2013·Chest·Hayley B GershengornHannah Wunsch
Mar 14, 2009·The Surgical Clinics of North America·Stephen F Lowry
Oct 18, 2008·Journal of the American College of Surgeons·Matthew J SenaGrant E O'Keefe
May 28, 2008·Current Problems in Surgery·George C Velmahos, Hasan B Alam
Apr 30, 2015·JPEN. Journal of Parenteral and Enteral Nutrition·Brodie ParentGrant O'Keefe
Jun 6, 2009·Journal of the Royal Army Medical Corps·J HenningS Price
Jun 7, 2012·Critical Care Nursing Quarterly·Natalia BaileyKatie Farver
Nov 1, 2013·Revista do Colégio Brasileiro de Cirurgiões·Alberto Bicudo-SalomãoJosé Eduardo de Aguilar-Nascimento

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