Perioperative Nutrition in Abdominal Surgery: Recommendations and Reality

Cerantola, Yannick; Grass, Fabian; Cristaudi, Alessandra; Demartines, Nicolas; Schäfer, Markus; Hübner, Martin

doi:10.1155/2011/739347

Cited by 68 publications

(65 citation statements)

References 59 publications

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“…3) It was internally and externally validated, and correlates with other biological screening tools. 25,26 However, in the current study NRS did not correlate with a biological measure since hypoalbuminemia was found in only 21% of patients. This might be explained by the relatively acute (within 0 to 4 weeks) onset of malnutrition in some patients.…”

Section: Discussioncontrasting

confidence: 73%

Are Patients at Nutritional Risk More Prone to Complications after Major Urological Surgery?

et al. 2013

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Purpose: The nutritional risk score is a recommended screening tool for malnutrition. While a nutritional risk score of 3 or greater predicts adverse outcomes after digestive surgery, to our knowledge its predictive value for morbidity after urological interventions is unknown. We determined whether urological patients at nutritional risk are at higher risk for complications after major surgery than patients not at nutritional risk. Materials and Methods:We performed a prospective observational study in consecutive patients undergoing major surgery. A priori sample calculation resulted in a study cohort of 220 patients. Interim analysis was planned after 110 patients. The nutritional risk score was assessed preoperatively by a specialized study nurse. Nutritional care was standardized in all patients. Postoperative complications were defined previously using the standardized Dindo-Clavien classification. The primary end point was 30-day morbidity. Univariate and multivariate analysis was performed to identify predictors of complications. Results:The study was discontinued due to significant results after interim analysis. A total of 125 patients were included in analysis from June 2011 to June 2012 and 15 were excluded because of incomplete data. Of 51 patients at nutritional risk 38 (74%) presented with at least 1 complication compared to 28 of 59 controls (47%). Patients at nutritional risk were at threefold risk for compli-cations on univariate and multivariate analysis (OR 3.3, 95% CI 1.3e8.0). Cys-tectomy was the only other predictor of morbidity (OR 10, 95% CI 2e48).Conclusions: Patients at nutritional risk are more prone to complications after major urological procedures. Whether this increased morbidity can be reversed by perioperative nutritional support should be studied.

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Section: Discussioncontrasting

confidence: 73%

Are Patients at Nutritional Risk More Prone to Complications after Major Urological Surgery?

et al. 2013

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“…[9][10][11] After surgery, maintenance of a hypermetabolic state due to the inflammatory response caused increase in the secretion of cytokines and stress hormones. In adults, trauma or surgery causes a brief, 2∼4…”

Section: Discussionmentioning

confidence: 99%

Determination of the Stress Factor Calculated from the Changes in the Measured Resting Energy Expenditure with Indirect Calorimetry in Patients Undergoing Pancreaticoduodenectomy

Kim¹,

Cho²,

Kim³

et al. 2017

J Clin Nutr

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Purpose: To predict the energy expenditure using the stress factor representing the ratio of the metabolic variation between pre-operation and post-operation in a pancreaticoduodenectomy (PD). Methods: This was a prospective study conducted on 17 patients (11 males and 6 females) who underwent PD at Chonbuk National University Hospital between March 2010 and October 2011. The rest energy expenditure was measured by indirect calorimetry 1 day before and 3 days after surgery. The height, weight, and fat free mass were also measured 1 day before surgery. Results: The mean measured rest energy expenditure 1 day before PD (mREE pre ) and 3 days after PD (mREE post ) were significantly different (16.8±2.6 vs. 18.8±3.5 kcal/kg/d, P=0.0076). The stress factor, representing the ratio of the metabolic changes between pre-and post-PD, was 1.12±0.17. The recommended energy requirement for PD patients is estimated to be 23∼24 kcal/ideal body weight/d [determined from the measured preoperative rest energy expenditure (16.8±2.6 kcal/kg/d)×activity factor (1.2∼ 1.3)×stress factor (1.12)]. Conclusion: PD patients maintained a hypermetabolic status and the applicable stress factor was 1.12.

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“…The role of preoperative nutritional support is to improve undernutrition before surgery, while postoperative nutrition aims at maintaining nutritional status in the catabolic period after surgery. The timing of nutritional support is widely debated [17]. Regarding perioperative nutrition support, the ESPEN guidelines on enteral nutrition in surgery and organ transplantation recommend that patients with severe nutritional risk should receive nutritional support 10-14 days prior to major surgery even if it means delaying surgery.…”

Section: Discussionmentioning

confidence: 99%

Effects of the Oral Nutritional Supplement Containing Arginine, Glutamine, and Hydroxymethylbutyrate (Abound®) on Healing of Colonic Anastomoses in Rats

et al. 2015

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We evaluated the effects of the oral nutritional supplement containing arginine, glutamine, and hydroxymethylbutyrate (Abound®) on healing of colonic anastomoses in experimental rat model. Seventy WistarAlbino male rats were divided into seven groups. Colon transection and anastomosis were performed in all groups except for the sham group. In groups 2 and 5, rats were fed with standard rat chow after the operation. Oral nutritional supplement was added to standard nutrition for 3 days postoperatively in group 3 and 7 days in group 6 and preoperative 7 days plus postoperative 3 days in group 4 and preoperative 7 days plus postoperative 7 days in group 7. Bursting pressures were measured, adhesions were evaluated, and tissue samples were taken for measurement of tissue hydroxyproline levels and for histopathological examination. The usage of oral nutritional supplement had positive effects on bursting pressures, tissue hydroxyproline levels, and histopathological findings of anastomoses, but feeding with oral nutritional supplement both preoperatively and postoperatively had no additive effect on these parameters when compared with the groups that were fed only postoperatively. The mixture of arginine, glutamine, and hydroxymethylbutyrate may be safely used for achieving better healing results after colonic anastomoses.

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Perioperative Nutrition in Abdominal Surgery: Recommendations and Reality

Cited by 68 publications

References 59 publications

Are Patients at Nutritional Risk More Prone to Complications after Major Urological Surgery?

Are Patients at Nutritional Risk More Prone to Complications after Major Urological Surgery?

Determination of the Stress Factor Calculated from the Changes in the Measured Resting Energy Expenditure with Indirect Calorimetry in Patients Undergoing Pancreaticoduodenectomy

Effects of the Oral Nutritional Supplement Containing Arginine, Glutamine, and Hydroxymethylbutyrate (Abound®) on Healing of Colonic Anastomoses in Rats

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