The impact of a multidisciplinary Nutritional Support Service (NSS) on the reduction of complication was evaluated in 78 consecutive patients who received total parenteral nutrition (TPN) on the same VA surgical service. Patients were placed into one of three groups (pre-NSS, transition-NSS, post-NSS) based on the evolution of the NSS. A significant reduction in catheter sepsis was observed and was attributable to the establishment of an NSS, specifically, a nurse specialist and protocols for catheter insertion and care.

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The objective of this paper is to compare the complications and costs of early postoperative parenteral and enteral nutrition in trauma patients. The research plan was to review the relevant prospective, randomized, clinical trials comparingparenteralwith enteral nutrition in trauma patients. Data were pooled and analyzed for infectious and gastrointestinal complications reported in the trials. Economic costs were used to evaluate the therapeutic expense associated with each route ofnutrition support. The results indicated that parenteral nutrition has greater infectious complications and greater associated therapeutic costs than enteral nutrition and thus should be used only in cases in which it is truly indicated.