Strategies to attenuate the catabolic response to surgery and improve perioperative outcomes

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

“…Post‐operative protein catabolism is characterised by a net loss of functional and structural body protein. Metabolically healthy patients lose between 40 and 80 g of nitrogen after elective open abdominal operations, equivalent to 1.2–2.4 kg wet skeletal muscle 26. Also, protein losses after abdominal surgery are 50% greater in insulin resistant patients than in those who are not 27.…”

The Impact of Glutamine Dipeptide–Supplemented Parenteral Nutrition on Outcomes of Surgical Patients

“…After elective surgery, patients have a catabolic response, with alteration in carbohydrate and protein metabolism 7 . Characteristic features are hyperglycemia and cumulative nitrogen losses, which may increase the risk of infection, delay wound healing, and diminish muscle strength after surgery, resulting in a prolonged hospital stay 13 . Several clinical trials have demonstrated that GLN supplementation improved postoperative nitrogen balance 14 ‐ 17 , 10 and immune function 11 , 14 , 17 .…”

Impact of Complete Parenteral Nutrition on Metabolic Processes in Cancer Patients in the Early Postoperative Period

“…В п о м о щ ь п р а к т и ч е с к о м у в р а ч у лее быстром введении (7-8 мг/кг/мин) утилизация глюкозы становится недостаточной, что приводит к раз витию гипергликемии [21]. В нашем исследовании па циенты получали глюкозу в соответствии с рекоменда циями Европейской ассоциации парентерального и энтерального питания (ESPEN) [7].…”