To compare the effects of early initiation of supplemental parenteral nutrition versus late initiation of on the incidence of the combined nosocomial postoperative infection rate in patients at high nutritional risk after major emergency abdominal surgery.
A prospective, randomized controlled, multicenter clinical trial.
The aim of this study is to investigate the effect of early, supplementary parenteral nutrition following emergency laparotomy.
Currently, parenteral nutrition is used in postoperative patients if or when oral or enteral nutrition is not feasible. However, little data exists on the optimal timing of parenteral nutrition.
Oral and enteral nutrition is encouraged. Participants will randomized on the second postoperative day if their calorie intake (oral + enteral) is below 30% of the calculated requirement. Patients will be randomized to early (postoperative day 2) or postponed (postoperative day 5) start of parenteral nutrition.
The combined oral + enteral + parenteral calorie target is 70-80% of the calculated requirement. Participants in the postponed group will be re-assessed on postoperative day 5, and if their calorie intake is less than 50% parenteral nutrition will be administered.
The intervention will continue until oral + enteral intake is at least 70% of the calculated requirement or the participant is at his/her habitual intake.