• David Plurad, Donald Green, Kenji Inaba, Howard Belzberg, Demetrios Demetriades, and Peter Rhee.
• University of Southern California and Los Angeles County Hospital Division of Trauma/Surgical Critical Care, Los Angeles, CA 90033, USA. plurad@usc.edu
• Injury. 2009 May 1;40(5):511-5.

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

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