Combination enteral and parenteral nutrition in critically ill patients: harmful or beneficial? A systematic review of the evidence

A combination of enteral (EN) and parenteral nutrition (PN) is often used as a strategy to optimize nutritional intake in critically ill patients; however, the effects of this intervention on clinically important outcomes have not been widely studied. This paper systematically reviewed studies that...

Full description

Saved in:
Bibliographic Details
Published in:Intensive care medicine 2004-08, Vol.30 (8), p.1666-1671
Main Authors: DHALIWAL, Rupinder, JUREWITSCH, Brian, HARRIETHA, Darlene, HEYLAND, Daren K
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Bibliographic data bases
Biological and medical sciences
Clinical outcomes
Confidence intervals
Critical Care - methods
Enteral Nutrition
Hospitals
Humans
Intensive care
Intensive care medicine
Intervention
Medical sciences
Mortality
Nutrition
Parenteral Nutrition
Systematic review
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A combination of enteral (EN) and parenteral nutrition (PN) is often used as a strategy to optimize nutritional intake in critically ill patients; however, the effects of this intervention on clinically important outcomes have not been widely studied. This paper systematically reviewed studies that compare EN + PN to enteral nutrition (EN) alone in critically ill patients. We searched bibliographic databases, personal files, and relevant reference lists to identify randomized controlled trials that compared combination EN + PN to EN alone. Only five studies met the inclusion criteria. In all these studies PN was started at the same time as EN in the experimental group. When the results of these trials were aggregated, EN + PN had no significant effect on mortality. There was no difference between the two groups in rates of infectious complications, length of hospital stay, or ventilator days. In critically ill patients who are not malnourished and have an intact gastrointestinal tract, starting PN at the same time as EN provides no benefit in clinical outcomes over EN alone. More research is needed to determine the effects of combination EN + PN on clinical outcomes in critically ill patients who are poorly intolerant to EN.
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-004-2345-y