The indications for providing nutrients by the enteral or intravenousroute (nutritional support) are not well defined, and the efficacyof nutritional support in many circumstances is unproved. Nonetheless,nutritional support is widely used for several reasons: malnutritionis common in hospitalized patients,1,2 there is an associationbetween malnutrition and increased morbidity3,4 and mortality,5it seems intuitively likely that well-nourished patients willrespond most favorably to treatment, nutritional support canbe administered safely to most patients, and clinical trialsindicate that it is beneficial in selected patients.6,7,8,9,10
Virtually all patients can be fed intravenously or enterally,because of the development . . . [Full Text of this Article]
Identification of Malnourished Patients
Indications for Nutritional Support
Major Elective Surgery
Major Trauma
Bone Marrow Transplantation
Unproved Benefits of Nutritional Support
Chemotherapy and Radiation Therapy for Cancer
Acquired Immunodeficiency Syndrome
Gastrointestinal Tract Dysfunction
Liver Failure
Renal Failure
Optimal Route of Delivery and Composition of Nutritional Formulas
Benefits and Costs of Nutritional Support
Future Directions and Conclusions
Source Information
From the Division of Surgical Oncology and the Nutrition Support Service, Massachusetts General Hospital and Harvard Medical School, Boston.
Address reprint requests to Dr. Souba at Massachusetts General Hospital, Cox Bldg., Rm. 626, 100 Blossom St., Boston, MA 02114.
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