Parenteral nutrition and nutritional support of surgical patients: reflections, controversies, and challenges.

摘要

An abridged background of the history, cause, and nature of early controversies related to the development and clinical application of total parenteral nutrition (TPN) is presented, followed by discussions of highlights of some of the more prominent controversies that continue to prevail, including nutritional support of geriatric patients with and without cancer, the importance of maintenance of normal glycemia, the primacy of nutrition support teams, and TPN versus total enteral nutrition. Reflections related to nutritional support and TPN are interspersed throughout the discussions, together with a compilation of legacies of TPN to the modern practice of medicine.