Early Enteral Nutrition Within 24 h of Intestinal Surgery Versus Later Commencement of Feeding: A Systematic review and Meta-analysis

Lewis, Stephen J.; Andersen, Henning; Thomas, Steve

doi:10.1007/s11605-008-0592-x

Cited by 416 publications

(281 citation statements)

References 21 publications

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“…Early recommencement of post‐operative nutrition has been shown to benefit the patient 52. However, most of the available data are from patients undergoing surgery in a traditional care programme, and very little is known about the effects of nutrition in a modern ERAS programme.…”

Section: Metabolic Homoeostasismentioning

confidence: 99%

Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

Scott

Baldini

Fearon

et al. 2015

Acta Anaesthesiol Scand

346

198

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BackgroundThe present article has been written to convey concepts of anaesthetic care within the context of an Enhanced Recovery After Surgery (ERAS) programme, thus aligning the practice of anaesthesia with the care delivered by the surgical team before, during and after surgery.MethodsThe physiological principles supporting the implementation of the ERAS programmes in patients undergoing major abdominal procedures are reviewed using an updated literature search and discussed by a multidisciplinary group composed of anaesthesiologists and surgeons with the aim to improve perioperative care.ResultsThe pathophysiology of some key perioperative elements disturbing the homoeostatic mechanisms such as insulin resistance, ileus and pain is here discussed.ConclusionsEvidence‐based strategies aimed at controlling the disruption of homoeostasis need to be evaluated in the context of ERAS programmes. Anaesthesiologists could, therefore, play a crucial role in facilitating the recovery process.

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Section: Metabolic Homoeostasismentioning

confidence: 99%

Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

Scott

Baldini

Fearon

et al. 2015

Acta Anaesthesiol Scand

346

198

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“…In addition, early postoperative oral feeding has been shown to be feasible in patients undergoing major surgery, and no side effects have been reported. 53 The physiological advantage of feeding at a time of catabolic stress relates to the increased stimulation of insulin production that subsequently inhibits the breakdown of protein. This then facilitates incorporation of the amino acids -made available by the feeding -into protein synthesis.…”

Section: Perioperative Feedingmentioning

confidence: 99%

Physiologic considerations of Enhanced Recovery After Surgery (ERAS) programs: implications of the stress response

Carli

2014

Can J Anesth/J Can Anesth

162

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Purpose Enhanced Recovery After Surgery (ERAS) programs have increasingly attracted the attention of clinicians who are intent on minimizing postoperative morbidity, decreasing variability in surgical care, and containing hospital costs. The purpose of this review is to discuss the relevant pathophysiology of the surgical stress response and its associated mechanisms that regulate important metabolic changes.

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“…A Cochrane review in 2006 found a direction of effect towards a reduction in complications and mortality rate, 65 and in an update to their original metanalysis, Lewis and colleagues confirmed no benefit to keeping patients nothing by mouth (NBM) postoperatively, a reduction in complications and a reduced mortality rate; although, the mechanism for reduced mortality remains unclear. 66 …”

Section: Postoperative Nutritionmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Melnyk

Casey

Black

et al. 2013

CUAJ

275

120

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Radical cystectomy with pelvic lymph node dissection remains the standard treatment for patients with muscle invasive bladder cancer. Despite improvements in surgical technique, anesthesia and perioperative care, radical cystectomy is still associated with greater morbidity and prolonged in-patient stay after surgery than other urological procedures. Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response following surgery. The key elements of ERAS protocols include preoperative counselling, optimization of nutrition, standardized analgesic and anesthetic regimens and early mobilization. Despite the significant body of evidence indicating that ERAS protocols lead to improved outcomes, they challenge traditional surgical doctrine, and as a result their implementation has been slow.The present article discusses particular aspects of ERAS protocols which represent fundamental shifts in surgical practice, including perioperative nutrition, management of postoperative ileus and the use of mechanical bowel preparation.

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Early Enteral Nutrition Within 24 h of Intestinal Surgery Versus Later Commencement of Feeding: A Systematic review and Meta-analysis

Cited by 416 publications

References 21 publications

Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

Physiologic considerations of Enhanced Recovery After Surgery (ERAS) programs: implications of the stress response

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

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