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Letters
October 20, 1999

Total Parenteral Nutrition for Critically Ill Patients

Author Affiliations
 

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;282(15):1423-1425. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-15-jac90009

To the Editor: Dr Heyland and colleagues1 conclude that TPN in critically ill patients has no benefit and that it may increase complications and possibly mortality, except for severely malnourished patients in whom complications are reduced but not mortality. However, several points require clarification. First, some studies included in the meta-analysis compared TPN with fluids plus "usual enteral diet." These studies may show the benefit of enteral nutrition and not necessarily the harmful effects of TPN.

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