Randomized Studies Evaluating Total Parenteral Nutrition in Surgical Patients
| Study | Methods score (max 14) | Patients (no.) | Intervention | Major complications | Mortality | Hospital stay, d | |||
|---|---|---|---|---|---|---|---|---|---|
| TPN | Control | TPN | Control | TPN | Control | ||||
| Muller et al, 1982 (6) | 3 | GI surgery (125) 60% malnourished | 10 d preop; no lipids | 11/66 | 19/59 | 3/66 | 11/59 | n/a | |
| Veterans Affairs Total Parenteral Nutrition Cooperative Study Group, 1991 (7) | 10 | Thoracoabdominal surgery (395) 100% malnourished | 7–15 d preop; lipids | 49/192 | 50/203 | 31/231 | 24/228 | n/a | |
| Bellantone et al, 1988 (8) | 6 | GI surgery (100) 100% malnourished | 7 d preop; lipids | 8/54 | 22/46 | 1/54 | 1/46 | n/a | |
| Fan et al, 1989 (15) | 10 | Surgery for esophageal cancer (40) 75% malnourished | 14 d preop; lipids | 17/20 | 15/20 | 6/20 | 6/20 | 15* | 16* |
| Figueras et al, 1989 (16) | 7 | GI surgery (49) 0% malnourished | 5 d postop; no lipids | 4/25 | 5/24 | 0/25 | 0/24 | 13 (6) | 11 (3) |
| Sandstrom et al,1993 (17) | 10 | Major surgery/trauma (300) 22% malnourished | 7–10 d postop; lipids | n/a | 12/150 | 10/150 | n/a | ||
| Hu et al, 1998 (18) | 3 | Spinal surgery (40) 0% malnourished | 7 d postop; lipids | 7/16 | 8/19 | 0/16 | 0/19 | n/a | |
| Reilly et al, 1990 (19) | 7 | Liver transplantation (18) 100% malnourished | 7 d postop; lipids | n/a | 0/8 | 2/10 | 67 (29) | 47 (19) | |
| Hwang et al,1993a (20) | 5 | Gastric surgery (42) ?% malnourished | 7 d postop; lipids | 0/12 | 0/16 | 0/12 | 0/16 | n/a | |
| Hwang et al, 1993b (20) | 5 | Gastric surgery (42) ?% malnourished | 7 d postop; no lipids | 0/14 | 0/16 | 0/14 | 0/16 | n/a | |
| Muller et al, 1986 (21) | 4 | GI surgery (105) ?% malnourished | 10 d preop; lipids | 17/46 | 19/59 | 10/46 | 11/59 | n/a | |
| Garden et al, 1983 (27) | 6 | GI surgery (20) ?% malnourished | 4 d postop; no lipids | n/a | 0/10 | 1/10 | 14 (4) | 18 (10) | |
| Hogbin et al, 1984 (28) | 7 | GI surgery (43) ?% malnourished | 5 d postop; no lipids | n/a | n/a | n/a | |||
| Doglietto et al, 1996 (29) | 10 | GI surgery (678) ?% malnourished | 5 d postop; no lipids | 66/338 | 71/340 | 16/338 | 12/340 | n/a | |
| Jimenez et al, 1995 (30) | 5 | GI surgery (75) 100% malnourished | 5 d postop; no lipids | 6/60 | 3/15 | 4/60 | 1/15 | 9 (6) | 12 (8) |
| Brennan et al, 1994 (31) | 8 | Pancreatic resection (117) ?% malnourished | ? d postop; lipids | 27/60 | 13/57 | 4/60 | 1/57 | 16 (7–72)* | 14 (6–88)* |
| Askanazi et al, 1986 (32) | 3 | Radical cysectomy (35) ?% malnourished | ? d postop; lipids | 1/22 | 2/13 | 0/22 | 2/13 | 17*† | 24*† |
| Thompson et al, 1981 (33) | 4 | GI surgery (21) 100% malnourished | 5 d preop; no lipids | 2/12 | 1/9 | 0/12 | 0/9 | n/a | |
| Fan et al, 1994 (34) | 7 | Surgery for hepatocellular cancer (124) 26% malnourished | 7d preop and postop; lipids | 22/64 | 33/60 | 5/64 | 9/60 | n/a | |
| Abel et al, 1976 (35) | 4 | Cardiac surgery (44) 100% malnourished | 5 d postop; no lipids | n/a | 4/20 | 3/24 | 19 (6) | 18 (6) | |
| Smith and Hartemink, 1988 (36) | 7 | GI surgery (34) 100% malnourished | 10 d preop; no lipids | 3/17 | 6/17 | 1/17 | 3/17 | 44 (13) | 38 (10) |
| Holter and Fischer, 1977 (37) | 5 | GI surgery (56) 100% malnourished | 3 d preop; no lipids | 4/30 | 5/26 | 2/30 | 2/26 | n/a | |
| Meguid et al, 1988 (38) | 4 | GI surgery (64) 100% malnourished | 9 d preop; lipids | n/a | 1/32 | 0/34 | 10 (6–30)* | 14 (9–30)* | |
| Woolfson and Smith, 1989 (39) | 10 | Thoracoabdominal surgery (122) ?% malnourished | 6 d postop; lipids | 6/62 | 4/60 | 8/62 | 8/60 | 14 (9–64)* | 13 (9–95)* |
| Von Meyenfeldt et al, 1992 (40) | 7 | GI surgery (101) 29% malnourished | 10 d preop; lipids | 6/51 | 7/50 | 2/51 | 2/50 | 36 (17) | 32 (22) |
| Yamada et al, 1983 (41) | 3 | Gastric surgery (62) ?% malnourished | 18 d postop; lipids | 0/29 | 5/28 | 0/29 | 1/28 | n/a | |
| Gys et al, 1990 (42) | 7 | Colorectal surgery (20) 0% malnourished | 6 d postop; lipids | 1/10 | 1/10 | 0/10 | 0/10 | n/a | |
| Freund et al, 1979 (43) | 8 | GI surgery (35) 0% malnourished | 5 d postop; no lipids | 0/25 | 0/10 | 0/25 | 0/10 | 17 (2.3) | 19 (2.9) |
* Median (range) otherwise reported as mean (standard deviation).
↵† No range specified.
n/a = not available, GI = gastrointestinal.