TPN-related digestive complications in critically ill patients

The investigation of critically ill patients reveals that parenteral nutrition (PN) is associated with a higher incidence of pneumonia, intra-abdominal abscess and possibly multiple organ dysfunction, than enteral nutrition. Extensive endocrine, metabolic and immunological changes occur in ICU patients, particularly those suffering from multiple injury, major burns, severe sepsis or severe inflammation. The purpose of this review will be first to describe briefly the gut dysfunction in critically ill patients and how gut dysfunction contributes to adverse outcomes. The discussion will then focus on additional harmful effects of TPN and on the potential therapeutic strategies to prevent and/or treat TPN-related digestive complications in these patients.