Evolução dos balanços energético e proteico no pós-operatório de pacientes submetidos a operações abdominais de grande porte

Abstract

Introduction: Monitoring the energy and protein balance is extremely important for assess and observe the nutritional status of surgical patients. The adequacy of the nutritional needs of those individuals represents a challenge in face of the various factors that interfere with nutritional status, tolerance and acceptance of nutritional therapy. Therefore, this study aimed to assess the evolution of the energy and protein balance in the postoperative period of patients undergoing major abdominal operations, in addition to observing the nutritional and clinical repercussions (postoperative compli- cations, period of hospitalization and death) associated with the inadequacy of the recommended nutritional needs for the surgical patient. Methods: Sixty-one patients undergoing elective abdominal operations had their resting energy expenditure measured in the immediate preoperative period. Nutritional, anthropometric and functional assessments were carried out, on immediate preoperative period, the 3rd and 7th postoperative days, in addition to 24-hour Food Recalls. Infusion data from enteral and parenteral diets for consumption and calorie and protein adequacy calculations were also registered. Clinical outcomes were collected from medical records. Results: 70.5% of the sample presented some degree of malnutrition prior to hospitalization, according to the Subjective Global Assessment (SGA). Regarding energy and protein balance, negative values were observed even in those patients who were using nutritional therapy, with no statistically significant difference between groups. There was a positive correlation between the negative energy balance and time of hospitalization, as well as a negative association between the nutritional status obtained by the SGA and postoperative complications. Conclusions: The caloric and protein needs of patients in the postoperative period were not reached, even among those who received nutritional therapy, impacting the time of hospitalization. More studies with other methodological strategies are suggested to evaluate the impact on the nutritional status of this scenario in surgical patients