Total parenteral nutrition and scientific evaluation of therapy

Defects in many controlled randomized trials in surgery were recently (1980) pointed out by van der Linden. The value of total parenteral nutrition (TPN) in connection with major surgical procedures and in the management of chronic inflammatory disease of the bowel is frequently debated. The present paper concerns some pitfalls in controlled randomized trials dealing with TPN. Emphasis is placed on the value of clinical judgement, common sense and appropriate experience in lieu of such trials, which in many instances are not feasible because of the extremely large numbers of patients required.