Copyright 1999 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.1999
In Reply: We acknowledge that the National
Institutes of Health, American Society for Parenteral and Enteral Nutrition,
and American Society for Clinical Nutrition sponsored review of nutritional
support concluded that preoperative TPN is beneficial in malnourished patients.1 The focus of our review article was on critically
ill patients managed in the intensive care unit, not the preoperative management
of surgical patients. Our findings suggest that the results of studies of
surgical patients are not generalizable to critically ill patients. Even if
the aggregated estimate of overall treatment effect is ignored (which we recommend
because of the heterogeneity present in the analysis), our review has made
clear that the limited amount of data for critically ill patients suggests
that the best estimate of treatment effect of TPN is consistent with doing
more harm than good.
Heyland DK, Drover JW. Contraceptive Effectiveness. JAMA. 1999;282(15):1423–1425. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-15-jac90009
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