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  1. Total parenteral nutrition in the critically III patient : A meta-analysis.

    Article - En anglais

    Context. - Nutritional support has become a standard of care for hospitalized patients, but whether total parenteral nutrition (TPN) affects morbidity and mortality is unclear.

    Objective

    - To examine the relationship between TPN and complication and mortality rates in critically ill patients.

    Data Sources

    - Computerized search of published research on MEDLINE from 1980 to 1998, personal files, and review of relevant reference lists.

    Study Selection

    - We reviewed 210 titles, abstracts, and papers.

    Primary studies were included if they were randomized clinical trials of critically ill or surgical patients that evaluated the effect of TPN (compared with standard care) on complication and mortality rates.

    We excluded studies comparing TPN with enteral nutrition.

    Data Extraction

    - Relevant data were abstracted on the methodology and outcomes of primary studies.

    Data were abstracted in duplicate, independently

    Data Synthesis.

    - There were 26 randomized trials of 2211 patients comparing the use of TPN with standard care (usual oral diet plus intravenous dextrose) in surgical and critically ill patients.

    When the results of these trials were aggregated, TPN had no effect on mortality (risk ratio [RR], 1.03 ; 95% confidence interval [Cl], 0.81-1.31).

    Patients who received TPN tended to have a lower complication rate, but this result was not statistically significant (RR, 0.84 ; 95% CI, 0.64-1.09). (...)

    Mots-clés Pascal : Nutrition, Voie parentérale, Postopératoire, Malade état grave, Malnutrition, Morbidité, Mortalité, Etude statistique, Randomisation, Etats Unis, Amérique du Nord, Amérique, Lipide, Etude comparative, Etude double insu, Cathéter, Adulte, Homme, Réanimation, Chirurgie

    Mots-clés Pascal anglais : Nutrition, Parenteral administration, Postoperative, Critically ill, Malnutrition, Morbidity, Mortality, Statistical study, Randomization, United States, North America, America, Lipids, Comparative study, Double blind study, Catheter, Adult, Human, Resuscitation, Surgery

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0070837

    Code Inist : 002B27B07. Création : 31/05/1999.