Development of Sustain™

Guenter, Peggi; Robinson, Lawrence A.; DiMaria‐Ghalili, Rose Ann; Lyman, Beth; Steiger, Ezra; Winkler, Marion F.

doi:10.1177/0148607111432760

Cited by 21 publications

(3 citation statements)

References 22 publications

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“…Malnutrition is an important modifiable risk factor for adverse outcomes after major surgery. Routine nutritional screening should be mandatory for all patients undergoing major surgery [25][26][27]. Several screening tools are available, and their usefulness in clinical practice is demonstrated.…”

Section: Perioperative Nutritionmentioning

confidence: 99%

“…Hendry et al [89] demonstrated the benefits of the routine use of oral laxatives combined with oral nutritional supplements in liver surgery patients within enhanced recovery pathway. Postoperative supplemental nutrition is only indicated in malnourished patients or in prolonged postoperative fasting ([5 days) such as when severe complications arise [25][26][27]. A systematic review confirmed that enteral nutrition should be preferred over parenteral nutrition after liver resections for better immune function and lower rates of infectious complications [90].…”

Section: Recommendationmentioning

confidence: 99%

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Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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Background Enhanced Recovery After Surgery (ERAS) is a multimodal pathway developed to overcome the deleterious effect of perioperative stress after major surgery. In colorectal surgery, ERAS pathways reduced perioperative morbidity, hospital stay and costs. Similar concept should be applied for liver surgery. This study presents the specific ERAS Society recommendations for liver surgery based on the best available evidence and on expert consensus. Methods A systematic review was performed on ERAS for liver surgery by searching EMBASE and Medline. Five independent reviewers selected relevant articles. Quality of randomized trials was assessed according to the Jadad score and CONSORT statement. The level of evidence for each item was determined using the GRADE system. The Delphi method was used to validate the final recommendations. Results A total of 157 full texts were screened. Thirty-seven articles were included in the systematic review, and 16 of the 23 standard ERAS items were studied specifically for liver surgery. Consensus was reached among experts after 3 rounds. Prophylactic nasogastric intubation and prophylactic abdominal drainage should be omitted. The use of postoperative oral laxatives and minimally invasive surgery results in a quicker bowel recovery and shorter hospital stay. Goal-directed fluid therapy with maintenance of a low intraoperative central venous pressure induces faster recovery. Early oral intake and mobilization are recommended. There is no evidence to prefer epidural to other types of analgesia. Conclusions The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.

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Section: Perioperative Nutritionmentioning

confidence: 99%

Section: Recommendationmentioning

confidence: 99%

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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“…Preoperatif nütrisyon: Karaciğer cerrahisinde ERAS protokolü gereği, riskli hastalarda (son 6 ay içinde %10-15 kilo kaybı, VKİ <18,5 kg/m 2 olması ve karaciğer ve böbrek disfonksiyonu olmadan serum albümin düzeyinin 3 g/dL altında olması) durumunda, preop optimizasyonun sağlanması için 7 günlük beslenme desteği önerilmektedir (10)(11)(12)(13) . Ağır derece malnütrisyonlu hastalarda (>%10 kilo kaybı) operasyon en az 2 hafta ertelenmeli, beslenme durumu iyileştirilmelidir.…”

Section: Ameliyat öNcesi Kilo Kaybıunclassified

The Enhanced Recovery After Surgery (ERAS) Protocol Implementations in Non-Colorectal Gastrointestinal Surgical Procedures; Bariatric, Hepatobiliary, Pancreaticoduodenectomy, Gastrectomy

Kalaycı¹,

Dagistanli²,

Kara³

2018

IKSST

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Kolorektal cerrahi ile başlayan ERAS uygulamalarında modern hasta bakımı yaklaşımı ile sağlanan ümit verici gelişmeler laparoskopiden, bariatrik cerrahiye, hepatikopankreatik cerrahi girişimlerden meme rekonstrüksiyonuna uzanmıştır. ERAS uygulamaları geleneksel yaklaşımın kanıta dayalı değerlendirmelerle ölçülmesi, örneklenmesi ve öğreti yoluyla hasta ve sağlık uygulayıcılarının yeniden deneyimlediği bakım sürecinin kontrolünü sağlamıştır. Tüm disiplinlerde daha kısa yatış süreleri elde edilirken, disiplin ayrıcalıklı yeni yaklaşım modaliteleri de gelişmiştir. Bariatrik cerrahide operasyon öncesi kilo kontrolü, alkolsigara kullanımı kısıtlamaları, sıvı ve solunum fizyolojisine yaklaşım farklılıkları, meme cerrahisinde opioid kullanımının azaltılması, pankreas tümörlerindeki girişimlerde biliyer drenaj gereksiniminin değerlendirilmesi vb. gibi farklılıkları getirmiştir. Hâlen tüm genel cerrahi disiplinlerde sürecin kontrolü ve sorgulanması amacıyla yeni metodoloji ve uygulamaların değerlendirildiği çalışmalara gereksinim vardır.

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Pediatric Home Parenteral Nutrition: Indications and Short‐Term Outcomes in a Large National Sample of Commercially Insured Children and Adolescents

Afolabi

Fairman

2018

Nut in Clin Prac

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Background To support families managing the complex requirements of home parenteral nutrition (HPN) in pediatric patients, health professionals need information about HPN indications and complications. Nationally representative information is limited. Methods A retrospective cohort analysis of the Truven Health MarketScan Commercial Claims and Encounters Database was performed and identified 683 patients aged ≤18 years receiving HPN during dates of service from January 2013 through September 2015. Baseline diagnoses were measured in the 30 days before the first observed HPN claim (preindex). Indications for older (aged 13–18 years) and younger (aged ≤12 years) children were compared. Hospital and emergency department (ED) utilization rates were measured for 30 postindex days. Results Gastrointestinal diagnoses and/or symptoms affected more than three‐quarters of patients. Short bowel syndrome was more common in younger than in older patients (24% vs 7%, respectively), and colitis was less common (13% vs 33%; both P < .01). Cancer was common in both age groups (22%–23%). Additional diagnoses indicating complex medical conditions were observed in a minority of patients: sepsis (9%), convulsions/epilepsy (7%), encephalopathy (3%), and immune deficiency (3%). From the preindex to postindex periods, rates of inpatient hospitalization declined from 78% to 41%, but hospital ED visits increased from 10% to 14%. In both periods, >95% of hospital and ED use was disease related. Conclusion In a nationally representative sample of commercially insured pediatric patients treated with HPN, complex medical conditions were common. Findings highlight the importance of American Society for Parenteral and Enteral Nutrition recommendations for team‐based care.

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Development of Sustain™

Cited by 21 publications

References 22 publications

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

The Enhanced Recovery After Surgery (ERAS) Protocol Implementations in Non-Colorectal Gastrointestinal Surgical Procedures; Bariatric, Hepatobiliary, Pancreaticoduodenectomy, Gastrectomy

Pediatric Home Parenteral Nutrition: Indications and Short‐Term Outcomes in a Large National Sample of Commercially Insured Children and Adolescents

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