[Peripheral parenteral nutrition: myth or reality?].
In the changing world of parenteral nutrition, daily doubts about methods arise which are not easily resolved. Controversy thus occurs on conceptual changes in energy requirements according to different levels of aggression, or as to the different utilisation of nutrients according to aggression, or referred to the most effective relations between energy and plastic substrates or the indication of and maintenance time for perioperative parenteral nutrition. While all these questions remain alive, recent years have seen the addition of a further polemical subject: is hypocalorific peripheral parenteral nutrition effective as nutritional backup for surgical patients? What are its indications and limitations? Answers to these questions require in the first place the establishment of criteria which clarify concepts that may not always be used precisely, perhaps due to their indiscriminate application (perioperative, peripheral, hypocalorific nutrition, etc.) After reviewing the physiological basis for this type of backup, we then make an evaluation of the effects of perioperative parenteral nutrition in terms of the evolution of the illness, before making a critical analysis of a variety of studies carried out by different writers, in an attempt to extract common conclusions from the diverse results on the efficacy of this type of nutritional backup.
García de Lorenzo
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Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, España.
Zarazaga
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A
Culebras
J M
JM
D006801:Humans; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000453:epidemiology / Q000628:therapy; D009747:Nutritional Physiological Phenomena / Q000502:physiology; D010288:Parenteral Nutrition / Q000379:methods / Q000639:trends*; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D015995:Prevalence