Elective nutritional support after major surgery: a prospective randomised trial

Effects of perioperative parenteral nutrition on wound healing and hospital stay in surgical patients: a randomized controlled study

“…Similar results were also observed by Freund et al (1979), 21 Woolfson and smith (1989), 24 however the hospital stay was short as compared to the present study. Von Meyenfeldt et al (1992) 25 in his study observed length of hospital stay more in the study group compared to control group (36 ± 17 verses 32 ± 22).…”

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

“…An earlier meta‐analysis by Braunschweig et al of patients ranging from pancreatitis, trauma, and inflammatory bowel to MOF, comparing use of PN with STD supports delay in PN in well‐nourished patients 55 . In hospitalized patients with the absence of preexisting malnutrition (when EN is not available), aggregating 7 studies 243 ‐ 249 showed that use of STD was associated with significantly reduced infectious morbidity (RR = 0.77; 95% CI, 0.65–0.91; P < .05) and a trend toward reduced overall complications (RR = 0.87; 95% CI, 0.74–1.03; P value not provided) compared with use of PN. In similar circumstances (critically ill, no EN available, and no evidence of malnutrition), Heyland aggregated 4 studies 246 , 247 , 250 , 251 in mostly surgical patients that showed a significant increase in mortality with use of PN (RR = 1.78; 95% CI, 1.11–2.85; P < .05) and a trend toward greater rate of complications (RR = 2.40; 95% CI, 0.88–6.58; P value not provided), when compared with STD 252 …”

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient:

“…24,92 Both meta-analyses compared use of PN with STD therapy (where no nutrition support therapy was provided). In critically ill patients in the absence of pre-existing malnutrition (when EN is not available), Braunschweig et al aggregated 7 studies [93][94][95][96][97][98][99] and showed that use of STD therapy was associated with significantly reduced infectious morbidity (RR = 0.77; 95% CI 0.65-0.91; P <.05) and a trend toward reduced overall complications (RR = 0.87; 95% CI 0.74-1.03; P not provided) compared to use of PN. 24 In the same circumstances (critically ill, no EN available, and no evidence of malnutrition), Heyland et al 92 aggregated 4 studies 96,97,100,101 and showed a significant increase in mortality with use of PN (RR = 0.1.78; 95% CI 1.11-2.85; P < .05) and a trend toward greater rate of complications (RR = 2.40; 95% CI 0.88-6.58; P not provided), when compared to STD therapy.…”