A 6-year review of total parenteral nutrition use and association with late-onset acute respiratory distress syndrome among ventilated trauma victims.
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.
Plurad
David
D
University of Southern California and Los Angeles County Hospital Division of Trauma/Surgical Critical Care, Los Angeles, CA 90033, USA. plurad@usc.edu
Green
Donald
D
Inaba
Kenji
K
Belzberg
Howard
H
Demetriades
Demetrios
D
Rhee
Peter
P
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