Patients Requiring Perioperative Nutritional Support

Enomoto, Takatoshi; Larson, Dawn M.; Martindale, Robert G.

doi:10.1016/j.mcna.2013.07.003

Cited by 21 publications

(10 citation statements)

References 123 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although immune dysfunction in surgical patients is multifactorial, recent studies suggest that the immune system may be modulated by the use of specific nutrients (immunonutrients), such as arginine, ω‐3 fatty acids, and nucleotides, which have the ability to ensure the defense mechanisms and intestinal barrier function and to modulate the inflammatory response. 24 , 25 There is evidence suggesting that supplements with immunomodulatory agents improve postoperative immunological response and speed up recovery from the immunodepression following surgical trauma and reduce the incidence of infectious complications. 21 , 26 …”

Section: Discussionmentioning

confidence: 99%

Perioperative Immunonutrition in Elderly Patients Undergoing Total Hip and Knee Arthroplasty: Impact on Postoperative Outcomes

Gonçalves

Nava

et al. 2020

J Parenter Enteral Nutr

View full text Add to dashboard Cite

Background: Arthroplasties in elderly patients are surgeries performed to ensure their quality of life. Perioperative care with specific nutrients can improve nutrition status and metabolic response to orthopedic surgeries, such as total knee arthroplasty (TKA) and total hip arthroplasty (THA). Methods: Retrospective study with elderly patients divided into 2 groups: control and immunonutrition. The immunonutrition group was instructed to start oral intake of the nutrition supplement 5 days before and to resume it 5 days after arthroplasty (200 mL, 3 times per day). The following were analyzed as primary and secondary outcomes: length of stay (LOS), infectious and noninfectious complications, need for intensive care unit (ICU), transfusion requirement, and C-reactive protein. Results: A total of 3015 elderly patients met the inclusion criteria: control group (n = 1398) and immunonutrition group (n = 1617). Overall, 81.2% were women and mean age was 72.6 ± 6.9 years. Immunonutrition group had a shorter LOS in hours (32.0 ± 19.4 vs 56.0 ± 26.4; P < .001) and lower rates of infectious complications (2.2% vs 4.6%; P < .001). Noninfectious complications and need for ICU also had lower rates in the immunonutrition group. In the logistic regression analysis, immunonutrition reduced the chance of infectious complications by 55% (odds ratio [OR], 0.45; 95% CI, 0.30-0.68; P < .001) even after adjusting for variables (OR, 0.45; 95% CI, 0.28-0.71; P < .001). Conclusion: Perioperative immunonutrition in elderly patients undergoing THA or TKA may shorten postoperative LOS and reduce infectious and noninfectious complications and transfusion requirement.

show abstract

Section: Discussionmentioning

confidence: 99%

Perioperative Immunonutrition in Elderly Patients Undergoing Total Hip and Knee Arthroplasty: Impact on Postoperative Outcomes

Gonçalves

Nava

et al. 2020

J Parenter Enteral Nutr

View full text Add to dashboard Cite

show abstract

“…[24] In spite of predicted significant weight loss after all types of gastrectomy, [25] peri-operative nutrition was a vital but often overlooked aspect of surgical care. [26] Following a gastrectomy, oral intake until recovery of bowel movements is restricted, although the early recovery after surgery (ERAS) program has recently recommended early oral feeding in the immediate postoperative period. [27] There have been a number of reports surrounding parenteral or enteral nutritional support for ICU patients with serious conditions or longterm hospitalized patients with complications.…”

Section: Discussionmentioning

confidence: 99%

Current Status of Calorie Support during the Immediate Post-Operative Period Following a Gastrectomy

et al. 2019

View full text Add to dashboard Cite

Purpose:The aim of this study was to elucidate the patterns of calorie support during the immediate postoperative period following a gastrectomy in gastric cancer patients. Materials and Methods: The clinicopathologic characteristics and nutritional parameters, including the actual infused amount of calories during the immediate postoperative period, were retrospectively collected and analyzed, This was data from a total 1,390 cases out of 1,404 patients who underwent curative gastrectomy at Results: The actual infused amount of calories during the immediate postoperative period (the first three days following surgery) was only 41.6% of the recommended average intake of calories, which was significantly lower (759.8±139.4 kcal/day vs 1,825.7±251.6 kcal/day, respectively). The target calories supply per unit body weight was 30 kcal/kg. According to the operative method, the average infused amount of calories was lower in open gastrectomy compared to when utilizing the minimal invasive methods (laparoscopic assisted or robot assisted gastrectomy) (742.11 kcal/day:11.7 kcal/kg vs 792.95 kacl/day:12.8 kcal/kg or 791.43 kcal/day:12.8 kcal/kg, respectively). In regards to the operative type, the average infused amount of calories was higher in subtotal gastrectomy compared to that in total gastrectomy (732.1 kcal/day:12.23 kcal/kg vs 689.5 kcal/day:11.7 kcal/kg, respectively). The female group had a higher calorie supply per unit body weight compared to that of the male group (766.0 kcal/day:13.7 kcal/kg vs 758.9 kcal/day:11.3 kcal/kg, respectively). According to body mass index (BMI), the low BMI group had a lower calorie intake compared to that of the normal or high BMI group (700.2 kcal/day:15.3 kcal/kg vs 761.8 kcal/day:13.6 kcal/kg vs 766.5 kcal/day:11.1 kcal/kg, respectively). The actual infused amount of calorie significantly varied day by day in all the groups (range: 31.52 kcal/day to 1,559.31 kcal/day). Conclusion: The actual calorie intake significantly varied from day-to-day. Moreover, the intake was significantly lower than the average daily recommended amount of calories following a gastrectomy in gastric cancer patients during the immediate postoperative period. (Surg Metab Nutr 2019;10:66-74)

show abstract

“…Ingestion of normal food and nutrition supplements from the day of surgery until oral intake is achieved is considered essential in an ERAS guideline to maintain body homeostasis 123 . After surgery, nutrition goals include providing sufficient support for wound healing and to avoid excessive loss of lean body mass 124 . Prolonged periods of fasting are associated with breakdown of the GI tract barrier function, atrophy of the endothelial microvilli, and decrease on the mass of gut‐associated lymphoid tissue 125 .…”

Section: Postoperative Elementsmentioning

confidence: 99%

Enhanced Recovery After Surgery

Steenhagen

2015

Nut in Clin Prac

View full text Add to dashboard Cite

Perioperative surgical care is undergoing a paradigm shift. Traditional practices such as prolonged preoperative fasting (nil by mouth from midnight), bowel cleaning, and reintroduction of oral nutrition 3-5 days after surgery are being shunned. These and other similar changes have been formulated into a protocol called Enhanced Recovery After Surgery (ERAS) pathway. It is a multimodal perioperative care pathway 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 an ERAS protocol include preoperative counseling, optimization of nutrition, standardized analgesic and anesthetic regimes, and early mobilization. The recent literature is heavily influenced by colorectal surgery, but the principles are now being applied to a wide range of disciplines. As they challenge traditional surgical doctrine, the implementation of ERAS guidelines has been slow, despite the significant body of evidence indicating that ERAS guidelines may lead to improved outcomes.

show abstract

Patients Requiring Perioperative Nutritional Support

Cited by 21 publications

References 123 publications

Perioperative Immunonutrition in Elderly Patients Undergoing Total Hip and Knee Arthroplasty: Impact on Postoperative Outcomes

Perioperative Immunonutrition in Elderly Patients Undergoing Total Hip and Knee Arthroplasty: Impact on Postoperative Outcomes

Current Status of Calorie Support during the Immediate Post-Operative Period Following a Gastrectomy

Enhanced Recovery After Surgery

Contact Info

Product

Resources

About