Immunonutrition in fast-track surgical patients — evidence review and adapted algorithm

Candela, Carmen Gómez; Milla, Samara Palma; Lozano, Elena Carrillo; Martino, Marcello Di; Alcolea, Natalia González; Roldán, Juana Olivar; Suárez-de-la-Rica, Alejandro; Lagunas, David Pestaña

doi:10.20960/nh.03405

Cited by 4 publications

(5 citation statements)

References 51 publications

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“…The increase in evidence regarding the use of these formulas for this type of patients has resulted in clinical guidelines recommending their use in upper digestive tract surgery [ 2 ]. Nevertheless, their use in an ERAS protocol is not yet fully recommended due to a lack of evidence in studies that included these protocols [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Immunonutrition on Cancer Patients Undergoing Surgery: A Scoping Review

et al. 2023

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Introduction: There is a large body of evidence about immunonutrition formulas; however, there are still doubts about their usefulness in routine clinical practice as compared with standard formulas. In the age of personalized medicine, new studies appear every year regarding several types of patients; therefore, an updated point of view on these formulas is necessary. Methods: The Embase database was searched from 2016 to 14 March 2022. Our criteria were articles published in English and Spanish. The evidence quality was evaluated using GRADEpro, and the review was developed according to the PRISMA statement. Results: In this review, a total of 65 unique records were retrieved; however, 36 articles did not meet the inclusion criteria and were thus excluded. In total, 29 articles were included in the final analysis. In the last few years, many meta-analyses have attempted to identify additional existing studies of surgical patients with certain pathologies, mainly oncological patients. Immunonutrition prior to oncological surgery was shown to cause a decrease in inflammatory markers in most of the studies, and the main clinical events that changed were the infectious complications after surgery. The length of stay and mortality data are controversial due to the specific risk factors associated with these events. Conclusions: The use of immunonutrition in patients who have undergone oncological surgery decreases the levels of inflammatory markers and infectious postoperative complications in almost all localizations. However, more studies are needed to assess the use of immunonutrition based on Enhanced Recovery After Surgery (ERAS) protocols.

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Section: Discussionmentioning

confidence: 99%

Effects of Immunonutrition on Cancer Patients Undergoing Surgery: A Scoping Review

et al. 2023

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“…Most of the patients reported in the case reports were previously healthy, including 3 adult women and 7-year-olds. In contrast, the reported patient’s immunity level was low at the time of hospitalization after cardiac surgery, which might be due to cardiac surgery injury, CPB, blood loss and malnutrition ( Angele and Faist, 2002 ; Gaudriot et al., 2015 ; Candela et al., 2021 ). A previous study showed that the bactericidal activity of neutrophil bactericidal agents against Staphylococcus aureus was decreased after cardiac surgery ( Mekontso-Dessap et al., 2005 ).…”

Section: Discussionmentioning

confidence: 92%

First report on severe septic shock associated with human Parvovirus B19 infection after cardiac surgery

Xiang

Wei

et al. 2023

Front. Cell. Infect. Microbiol.

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BackgroundHuman Parvovirus B19 (PB19) is a single-stranded DNA virus. Septic shock from viremia is rare with PB19; however, this infection can progress to life-threatening conditions. We report the first case of severe septic shock associated with a PB19 infection after cardiac surgery.Case PresentationA 50-year-old Chinese woman received elective double metal valve replacement, including the aortic valve and the mitral valve, under cardiopulmonary bypass (CPB) and suffered severe septic shock on postoperative day (PD) 30. Through the detection of PB19-specific nucleic acids in blister fluid and serum samples via metagenomic next-generation sequencing (mNGS), positive serum PB19 IgM and no other proven infection, acute PB19 infection was confirmed. After five days of combined treatment, no further fever or abdominal discomfort was noted, and the patient’s circulation gradually became stable without vasoactive medications.ConclusionPB19 may be an unrecognized cause of septic shock, rash, fever of unknown origin or multiple systemic signs and symptoms, especially in immunosuppressed and immunocompetent critically ill patients. Investigations for viral aetiology are needed.

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“…Adaptada de Gómez Candela C et al (2021) (25) Sobre los posibles efectos benéficos de la inmunonutrición en las patologías oncológicas se investiga desde hace 30 años. No obstante, es a partir del año 2000 cuando se ha intensificado la actividad investigativa.…”

Section: Nucleótidosunclassified

Inmunonutrición para pacientes sometidos a cirugía electiva de cáncer de cabeza y cuello vs nutrición enteral estándar

Ruosi

2023

MLS Health Nutr.

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La finalidad de esta revisión bibliográfica es examinar la evidencia científica más reciente sobre el efecto y los reales beneficios, en la recuperación postoperatoria, de la inmunonutrición enteral respecto a las fórmulas estándar, en pacientes que padecen cáncer de cabeza y cuello, sometidos a cirugía electiva. Las principales fuentes bibliográficas de elevado impacto científico, se han rescatado a partir de bases de datos como Medline, PubMed, Biblioteca Cochrane, Elsevier, Scielo y principales sociedades médicas oncológicas como: SEOM, NIH y guías clínicas como ESPEN. Existe una gran heterogeneidad entre los resultados examinados de las diferentes revisiones y metaanálisis, sobre el efecto de la inmunonutrición en las complicaciones postoperatorias. En general, los hallazgos indican un beneficio en el uso de la inmunonutrición, sin embargo, para el cáncer de cabeza y cuello se basan en evidencia de calidad deficiente por numerosas limitaciones, por lo que la comunidad científica no ha encontrado todavía un consenso común. Una investigación más prolífica podría confirmar tales resultados con mayores beneficios para la supervivencia del paciente y, consecuentemente, una menor estancia hospitalaria, que gravaría menos en los costes del sistema sanitario.

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Immunonutrition in fast-track surgical patients — evidence review and adapted algorithm

Cited by 4 publications

References 51 publications

Effects of Immunonutrition on Cancer Patients Undergoing Surgery: A Scoping Review

Effects of Immunonutrition on Cancer Patients Undergoing Surgery: A Scoping Review

First report on severe septic shock associated with human Parvovirus B19 infection after cardiac surgery

Inmunonutrición para pacientes sometidos a cirugía electiva de cáncer de cabeza y cuello vs nutrición enteral estándar

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