The DOI matches its Crossref record; 7 of the 7 references it cites were found in a registry or an index.
Perioperative Total Parenteral Nutrition in Surgical Patients
Open accessAbstract
BACKGROUND: We undertook this study to test the hypothesis that perioperative total parenteral nutrition (TPN) decreases the incidence of serious complications after major abdominal or thoracic surgical procedures in malnourished patients. METHODS: We studied 395 malnourished patients (99 percent of them male) who required laparotomy or noncardiac thoracotomy. They were randomly assigned to receive either TPN for 7 to 15 days before surgery and 3 days afterward (the TPN group) or no perioperative TPN (the control group). The patients were monitored for complications for 90 days after surgery. RESULTS: The rates of major complications during the first 30 days after surgery in the two groups were similar (TPN group, 25.5 percent; control group, 24.6 percent), as were the overall 90-day mortality rates (13.4 percent and 10.5 percent, respectively). There were more infectious complications in the TPN group than in the controls (14.1 vs. 6.4 percent; P = 0.01; relative risk, 2.20; 95 percent confidence interval, 1.19 to 4.05), but slightly more noninfectious complications in the control group (16.7 vs. 22.2 percent; P = 0.20; relative risk, 0.75; 95 percent confidence interval, 0.50 to 1.13). The increased rate of infections was confined to patients categorized as either borderline or mildly malnourished, according to Subjective Global Assessment or an objective nutritional assessment, and these patients had no demonstrable benefit from TPN. In contrast, severely malnourished patients who received TPN had fewer noninfectious complications than controls (5 vs. 43 percent; P = 0.03; relative risk, 0.12; 95 percent confidence interval, 0.02 to 0.91), with no concomitant increase in infectious complications. CONCLUSIONS: The use of preoperative TPN should be limited to patients who are severely malnourished unless there are other specific indications.
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Cites
Nutritional Assessment: A Comparison of Clinical Judgment and Objective Measurements
Baker, J. P., Detsky, A. S., Wesson, D. E., Wolman, S. L., Stewart, S., Whitewell, J., Langer, B., & Jeejeebhoy, K. N. (1982) · New England Journal of Medicine · doi:10.1056/nejm198204223061606 · Cited by 1,019
PREOPERATIVE PARENTERAL FEEDING IN PATIENTS WITH GASTROINTESTINAL CARCINOMA
Müller, J. M., Dienst, C., Brenner, U., & Pichlmaier, H. (1982) · The Lancet · doi:10.1016/s0140-6736(82)90212-4 · Cited by 488
Buzby, G., Knox, L., Crosby, L., Eisenberg, J., Haakenson, C., McNeal, G., Page, C., Reinhardt, G., & Williford, W. (1988) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/47.2.366 · Cited by 364
The link between nutritional status and clinical outcome: can nutritional intervention modify it?
Dempsey, D., Mullen, J., & Buzby, G. (1988) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/47.2.352 · Cited by 341
Buzby, G., Williford, W., Peterson, O., Crosby, L., Page, C., Reinhardt, G., & Mullen, J. (1988) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/47.2.357 · Cited by 293
Perioperative Parenteral Nutrition: A Meta-Analysis
DETSKY, A. S., BAKER, J. P., O'ROURKE, K., & GOEL, V. (1987) · Annals of Internal Medicine · doi:10.7326/0003-4819-107-2-195 · Cited by 283
Indications and effects of preoperative parenteral nutrition
Müller, J. M., Keller, H. W., Brenner, U., Walter, M., & Holzmüller, W. (1986) · World Journal of Surgery · doi:10.1007/bf01656090 · Cited by 143
Cited by
ESPEN guidelines on nutrition in cancer patients
Arends, J., Bachmann, P., Baracos, V., Barthelemy, N., Bertz, H., Bozzetti, F., Fearon, K., Hütterer, E., Isenring, E., Kaasa, S., et al. (2017) · Clinical Nutrition · doi:10.1016/j.clnu.2016.07.015 · Cited by 3,114
McClave, S. A., Martindale, R. G., Vanek, V. W., McCarthy, M., Roberts, P., Taylor, B., Ochoa, J. B., Napolitano, L., Cresci, G., the A.S.P.E.N. Board of Directors, et al. (2009) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607109335234 · Cited by 1,873
ESPEN practical guideline: Clinical Nutrition in cancer
Muscaritoli, M., Arends, J., Bachmann, P., Baracos, V., Barthelemy, N., Bertz, H., Bozzetti, F., Hütterer, E., Isenring, E., Kaasa, S., et al. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.02.005 · Cited by 1,702
White, J. V., Guenter, P., Jensen, G., Malone, A., Schofield, M., Academy Malnutrition Work Group, A.S.P.E.N. Malnutrition Task Force, & and the A.S.P.E.N. Board of Directors (2012) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607112440285 · Cited by 1,284
Alberda, C., Gramlich, L., Jones, N., Jeejeebhoy, K., Day, A. G., Dhaliwal, R., & Heyland, D. K. (2009) · Intensive Care Medicine · doi:10.1007/s00134-009-1567-4 · Cited by 975
Metadata
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1991-08-22
- Volume
- 325
- Issue
- 8
- Pages
- 525-532
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W4236793871
- Cited by
- 1,256
- References
- 7
- FWCI
- 37.61
- Type
- journal article
- Language
- en
- Open access
- bronze
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