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Enteral versus parenteral nutrition: a pragmatic study
N P Woodcock1, D Zeigler, M D Palmer
1Combined Gastroenterology Unit, Scarborough Hospital, Woodlands Drive, Scarborough YO12 6QL, UK.
Nutrition (Burbank, Los Angeles County, Calif.)
|February 13, 2001
Summary
Parenteral nutrition (TPN) is superior to enteral nutrition (EN) for patients with uncertain gastrointestinal function. TPN ensures better nutritional intake and fewer complications, while EN is linked to higher mortality and morbidity.
Area of Science:
- Clinical Nutrition
- Gastroenterology
- Critical Care Medicine
Background:
- Adjuvant nutritional support is crucial in patient care, yet optimal delivery methods remain debated.
- Enteral nutrition (EN) and total parenteral nutrition (TPN) are primary modalities, each with potential benefits and drawbacks.
Purpose of the Study:
- To compare EN and TPN regarding nutritional intake adequacy, septic and nonseptic morbidity, and mortality.
- To evaluate the efficacy of EN versus TPN in patients with varying degrees of gastrointestinal function.
Main Methods:
- A prospective pragmatic study involving 562 patients, categorized by clinician assessment of gastrointestinal function.
- Patients with inadequate function received TPN; those with adequate function received EN.
- Patients with uncertain gastrointestinal function were randomized to receive either TPN or EN.
Main Results:
- Inadequate nutritional intake was significantly higher in the randomized EN group (78.1%) compared to the randomized TPN group (25%).
- Complications related to delivery systems and feed-related morbidity were more frequent with EN.
- Overall mortality was higher in patients receiving EN compared to TPN, particularly in the randomized group.
Conclusions:
- Enteral nutrition is associated with a higher incidence of inadequate nutritional intake, delivery system complications, and feed-related morbidity compared to parenteral nutrition.
- No significant difference in septic morbidity was observed between EN and TPN.
- Parenteral nutrition is recommended for patients with uncertain gastrointestinal function to ensure adequate nutritional support and reduce complications.