Eleven studies (n=1,044) were included in the review: all were of a non-randomised design. Fours studies used concurrent controls, while seven used historical controls.
Five studies were excluded as they scored below the mean quality score of the identified studies; this left 11 eligible studies.
Seven studies reported catheter-related complications addressing mechanical or septic complications. All 6 studies that addressed mechanical complications reported a higher incidence of complications in patients under the management of physicians, compared with patients managed by a TPN team. Of the 7 studies that investigated catheter-related sepsis, five reported a reduction and two an increase in patients managed by a team.
Ten studies addressed the incidence of metabolic and electrolyte abnormalities. In four of the 5 identified studies that reported the incidence of total metabolic and total electrolyte abnormalities, patients managed by a team experienced fewer abnormalities; the other study found no statistically significant difference for this outcome.
All 5 studies addressing nutritional requirements reported more over- and underfeeding for patients not managed by TPN teams.
Two of 4 studies reported that patients managed by a team were more likely to be fed by the most appropriate route; the results of the other 2 studies were unclear.
Physicians complied with at least 50% of the recommendations made by the TPN team (based on 2 studies).