Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
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.
Weyandt D, Karzai W. Total Parenteral Nutrition for Critically Ill Patients. JAMA. 1999;282(15):1423–1425. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-15-jac90009
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: