The CALORIES trial compared parenteral nutrition (PN) versus enteral nutrition (EN) for critically ill patients who could not receive early enteral nutrition. The trial found:
- A PN was associated with higher 30-day mortality than EN
- B EN was associated with significantly lower ICU infection rates
- C No significant difference in 30-day mortality between PN and EN ✓
- D PN led to significantly higher rates of liver dysfunction
Correct answer: C. No significant difference in 30-day mortality between PN and EN
Explanation
The CALORIES (Calories Trial) randomized 2388 critically ill adults who could not meet caloric needs enterally to PN versus EN. No significant difference in 30-day mortality was found (33.1% PN vs. 34.2% EN; P=0.57). However, hypoglycaemia was less common with PN (3.7% vs. 6.2%). This challenged the dogma that enteral nutrition is always superior. EN was associated with more vomiting, while PN had fewer GI complications. Both routes are acceptable when one is not achievable.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.