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Intensive Care Medicine
Published in: Intensive Care Medicine 8/2004

01-08-2004 | Brief Report

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

Authors: Rupinder Dhaliwal, Brian Jurewitsch, Darlene Harrietha, Daren K. Heyland

Published in: Intensive Care Medicine | Issue 8/2004

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Abstract

Objective

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.

Methods

We searched bibliographic databases, personal files, and relevant reference lists to identify randomized controlled trials that compared combination EN + PN to EN alone.

Results

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.

Conclusions

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.
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Metadata
Title
Combination enteral and parenteral nutrition in critically ill patients: harmful or beneficial? A systematic review of the evidence
Authors
Rupinder Dhaliwal
Brian Jurewitsch
Darlene Harrietha
Daren K. Heyland
Publication date
01-08-2004
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 8/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-004-2345-y

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