Perioperative Nutritional Support

López, Jesús Manuel Morán; León, María Piedra; Unzueta, Marı́a Teresa Garcı́a; Espejo, María Ortiz; González, Miriam Hernández; López, Ruth Morán; Señarís, José Antonio Amado

doi:10.1016/j.cireng.2013.12.023

Cited by 1 publication

(1 citation statement)

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“…The prognostic role of metabolic stress in surgical patients encouraged the perioperative administration of energy and proteins (nutrition support) to meet postoperative requirements and prevented a further deterioration of nutrition status after surgery when periods of prolonged fasting and muscle catabolism are expected 14,17 . Nutrition supplements can influence outcomes, particularly in elderly patients, as their functional reserve is limited.…”

Section: Introductionmentioning

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

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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.

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Section: Introductionmentioning

confidence: 99%