Complications and Costs of Early Postoperative Parenteral Versus Enteral Nutrition in Trauma Patients

Abstract

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.

Toxic epidermal necrolysis; 15 years’ experience in a Dutch burns centre

“…Also, overestimation of the percentage TBSA, as can be the case with too crude a use of the 'rule of nines' or inclusion of the area of maculous, but not detached skin can contribute to incorrect prediction. The mean APACHE score in our study group was high (15), possibly explaining the relative large number of patients needing ventilatory and haemodynamic support. To tailor prediction of prognosis in this extraordinary illness, Bastuji-Garin et al .…”

“…Relevant comorbidity was grouped as neurological, metabolic, immune compromising (disease or use of immunosuppressive drugs), respiratory, cancerous or cardiac. APACHE II-score at time of admission to our burns centre averaged 15 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). The mean SCORTEN score was 2.68 (1)(2)(3)(4)(5).…”

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DGEM Guidelines Enteral Nutrition: Gastroenterology

“…Die Erhaltung der mukosalen Integrität sollte immer angestrebt werden. Eine niedervolumige jejunale Gabe einer Sondennahrung sollte auch parallel zur parenteralen Ernährung angestrebt werden [160,161].…”