Sway Desai presented the NEJM article: Early versus late parenteral nutrition in critically ill adults [PMID: 21714640] that evaluated parenteral nutritional support in the ICU setting in Europe, where formulations of TPN differ widely from what is available in the US. Overall, patients with early parenteral nutrition did not fare better than patients who were started on parenteral nutrition later.

In journal club, we discussed the many different potential outcomes listed by the authors of this paper of thus study. Ideally, outcomes will be determined in a research protocol a priori and will have relevance to both the research world and directly to patients. There are techniques for independent a priori determination of outcomes for clinical research as described in this recent paper, Using the Delphi technique to determine which outcomes to measure in clinical trials: recommendations for the future based on a systematic review of existing studies [PMID: 21283604].