A 6-year review of total parenteral nutrition use and association with late-onset acute respiratory distress syndrome among ventilated trauma victims.

Abstract

AIM:

To establish whether total parenteral nutrition (TPN) for ventilated trauma victims is associated with late-onset acute respiratory distress syndrome (ARDS) independent of ventilation and transfusion parameters.

METHOD:

Intensive care unit data over 6 years from a level I centre regarding all trauma victims > or = 16 years old who underwent mechanical ventilation within the first 48 h of admission were examined. Patients were prospectively followed for late ARDS. Variables were examined for significant changes over time and independent associations with late ARDS were determined.

RESULTS:

Of 2346 eligible patients among whom 404 (17.2%) were exposed to TPN, 192 (8.2%) met criteria for late ARDS. The incidence of late ARDS among those exposed to TPN was 28.7% (116/404) compared with 3.9% (76/1942) among those not so exposed. Adjustments for potential confounding associated risk factors were made.

CONCLUSIONS:

TPN administration is independently associated with late ARDS, and its use among critically ill trauma victims should be carefully scrutinised.

• Authors: David Plurad, Donald Green, Kenji Inaba, Howard Belzberg, Demetrios Demetriades, Peter Rhee
• Journal: Injury (Injury) Vol. 40 Issue 5 Pg. 511-5 (May 2009) ISSN: 1879-0267 [Electronic] Netherlands
• PMID: 19117556 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Critical Care
• Critical Illness
• Erythrocyte Transfusion
• Female
• Humans
• Incidence
• Injury Severity Score
• Inspiratory Capacity (physiology)
• Length of Stay
• Male
• Middle Aged
• Parenteral Nutrition, Total (adverse effects)
• Prospective Studies
• Regression Analysis
• Respiration, Artificial
• Respiratory Distress Syndrome (epidemiology, etiology)
• Water-Electrolyte Balance
• Wounds and Injuries (therapy)
• Young Adult