Elective nutritional support after major surgery: a prospective randomised trial

We investigated the possibility that morbidity and mortality might be reduced by giving seven days elective intravenous nutrition after major thoraco-abdominal procedures and total cystectomy. In a prospective parallel randomised double-blind comparison with a standard post-operative fluid regimen, intravenous nutrition had no effect on morbidity, mortality or duration of hospital stay in a group of 122 sequentially recruited patients. This was not due to poor comparability of the patient groups or to failure to give the prescribed treatment. A policy to give post-operative intravenous nutrition routinely to such patients is not likely to prove cost effective. There may be certain patients who might benefit, but we were unable to identify them with a simple pre-operative assessment.