Five heroin addicts with severe tetanus and its consequent catabolic state were managed with antitetanus therapy and central venous hyperalimentation. Adequate nutrition and maintenance of weight were achieved until enteral nutrition was resumed. This is the first documented use of total parenteral nutrition to meet the accelerated metabolic demands of severely ill patients with tetanus.
Parsa MH, Anderson MD, Richter RW. Central Venous Nutrition in Severe Tetanus. Arch Surg. 1972;105(3):420-423. doi:10.1001/archsurg.1972.04180090025006