Supplemental parenteral nutrition in critically ill patients

摘要

The study by Claudia Heiddeger and colleagues is of considerable interest to critical-care practitioners. We hope that the authors can clarify some of their findings. First, although the authors show that supplemental parenteral nutrition (SPN) is associated with decreased infectious complications between day 9 and day 28 in the intensive-care unit (ICU), they also observe a trend in increasing infectious complications between day 4 and day 8 (34% [52/153] vs 28% [43/152]). The total number of infectious events during and after the intervention is important. The greater risk of pneumonia occurring between day 4 and day 8 in the SPN group (35 vs 28 patients) suggests a possible limitation of early SPN. Second, it would be helpful if the authors could provide details on other infections. From data in table 2/we speculate that the frequency of other infections (2 vs 13 patients) significantly contribute to the total number of infectious complications between day 9 and day 28. We also would be interested in plausible explanation as to why non-pneumonic infections decreased in the SPN group.