title: A 6-year review of total parenteral nutrition use and association with late-onset acute respiratory distress syndrome among ventilated trauma victims.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.affiliation: University of Southern California and Los Angeles County Hospital Division of Trauma/Surgical Critical Care, Los Angeles, CA 90033, USA. plurad@usc.edu
authors.forename: David
authors.initials: D
authors.lastname: Plurad
authors.forename: Donald
authors.initials: D
authors.lastname: Green
authors.forename: Kenji
authors.initials: K
authors.lastname: Inaba
authors.forename: Howard
authors.initials: H
authors.lastname: Belzberg
authors.forename: Demetrios
authors.initials: D
authors.lastname: Demetriades
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
mesh_terms: D000293:Adolescent; D000328:Adult; D003422:Critical Care; D016638:Critical Illness; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007320:Inspiratory Capacity / Q000502:physiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D011446:Prospective Studies; D012044:Regression Analysis; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000453:epidemiology* / Q000209:etiology; D014882:Water-Electrolyte Balance; D014947:Wounds and Injuries / Q000628:therapy*; D055815:Young Adult