PPT Slide
Results of literature review
Reference: Heyland DK, Montalvo M, MacDonald S, Keefe L, Su XY, Drover JW. Total parenteral nutrition in the surgical patient: a meta-analysis. Can.J Surg. 2001;44:102-11
Patients type / studies included: 27 RCTs involving 2,907 surgical pts comparing the use of TPN (preop or postop) to standard care (usual oral diet ± IV dextrose)
Best Level of Evidence: Level II Internal validity score: 6 / 6
B2 - overall, TPN was associated with a reduction in complication rates (RR 0.81, 95%CI 0.61 to 1.01)
A2 - in studies of malnourished patients, TPN was significantly associated with a reduction in complication rates (RR 0.52 95%CI 0.30 to 0.91)
A2 - in studies where TPN was initiated preoperatively, there was a significant reduction in complication rates (RR 0.70 95%CI 0.52 to 0.92)
B2 - in studies with a lower methods score, there was a significant reduction in complication rates (RR 0.50, 95%CI 0.47 to 1.19)