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Parenteral versus enteral nutrition in the critically ill patient: a re-analysis of a flawed meta-analysis

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  1. Simpson F, Doig GS (2005) Parenteral vs. enteral nutrition in the critically ill patient: a meta-analysis of trials using the intention to treat principle. Intensive Care Med 31:12–23

    Article  PubMed  Google Scholar 

  2. Bistrian BR (2008) Parenteral vs. enteral nutrition? Crit Care Med 36:3133

    Article  PubMed  Google Scholar 

  3. Bistrian BR (2011) Death by total parenteral nutrition. Crit Care Med 39:2586

    Article  PubMed  Google Scholar 

  4. Ziegler TR (2009) Parenteral nutrition in the critically ill patient. N Engl J Med 361:1088–1097

    Article  PubMed  CAS  Google Scholar 

  5. Rapp RP, Young B, Twyman D, Bivins BA, Haack D, Tibbs PA, Bean JR (1983) The favorable effect of early parenteral feeding on survival in head-injured patients. J Neurosurg 58:906–912

    Article  PubMed  CAS  Google Scholar 

  6. McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, Ochoa JB, Napolitano L, Cresci G (2009) Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). JPEN 33:277–316

    Article  Google Scholar 

  7. Reignier J, Mercier E, Le Gouge A, Boulain T, Desachy A, Bellec F, Clavel M, Frat JP, Plantefeve G (2013) Effect of not monitoring residual gastric volume on risk of ventilator-associated pneumonia in adults receiving mechanical ventilation and early enteral feeding: a randomized controlled trial. JAMA 309:249–256

    Article  PubMed  CAS  Google Scholar 

  8. Casaer MP, Mesotten D, Hermans G, Wouters PJ, Schetz M, Meyfroidt G, van Cromphaut S, Ingels C (2011) Early versus late parenteral nutrition in critically ill adults. N Engl J Med 365:506–517

    Article  PubMed  CAS  Google Scholar 

  9. Kutsogiannis J, Alberda C, Gramlich L, Cahill NE, Wang W, Day AG, Dhaliwal R, Heyland DK (2012) Early use of supplemental parenteral nutrition in critically ill patients: results of an international multicenter observational study. Crit Care Med 39:2691–2699

    Google Scholar 

  10. Sena MJ, Utter GH, Cuschieri J, Maier RV, Tompkins RG, Harbrecht BG, Moore EE, O’Keefe GE (2008) Early supplemental parenteral nutrition is associated with increased infectious complications in critically ill trauma patients. J Am Coll Surg 207:459–467

    Article  PubMed  Google Scholar 

  11. Marik PE (2009) What is the best way to feed patients with pancreatitis? Curr Opin Crit Care 15:131–138

    Article  PubMed  Google Scholar 

  12. Elke G, Schadler D, Engel C, Bogatsch H, Frerichs I, Ragaller M, Scholz J, Brunkhorst F, Loffler M, Reinhart K, Weuleer N (2008) Current practice in nutritional support and its association with mortality in septic patients—results from a national prospective multicenter study. Crit Care Med 36:1762–1767

    Article  PubMed  Google Scholar 

  13. Rayes N, Hansen S, Seehofer D, Muller AR, Serke S, Bengmark S, Neuhaus P (2002) Early enteral supply of fiber and Lactobacilli versus conventional nutrition: a controlled trial in patients with major abdominal surgery. Nutrition 18:609–615

    Article  PubMed  Google Scholar 

  14. Gianotti L, Braga M, Vignali A, Balzano G, Zerbi A, Bisagni P, Di CV (1997) Effect of route of delivery and formulation of postoperative nutritional support in patients undergoing major operations for malignant neoplasms. Arch Surg 132:1222–1229

    Article  PubMed  CAS  Google Scholar 

  15. Reynolds JV, Kanwar S, Welsh FK, Windsor AC, Murchan P, Barclay GR, Guillou PJ (1997) Does the route of feeding modify gut barrier function and clinical outcome in patients after major upper gastrointestinal surgery? JPEN 21:196–201

    Article  CAS  Google Scholar 

  16. Woodcock NP, Zeigler D, Palmer MD, Buckley P, Mitchell CJ, MacFie J (2001) Enteral versus parenteral nutrition: a pragmatic study. Nutrition 17:1–12

    Article  PubMed  CAS  Google Scholar 

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The authors of this paper have no financial interest in any of the products mentioned in this paper.

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Correspondence to Paul E. Marik.

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An author’s reply to this comment is available at: doi:10.1007/s00134-013-2856-5.

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Marik, P.E., Hooper, M. Parenteral versus enteral nutrition in the critically ill patient: a re-analysis of a flawed meta-analysis. Intensive Care Med 39, 979–980 (2013).

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