Perioperative Use of Arginine-supplemented Diets: A Systematic Review of the Evidence

Drover, John W.; Dhaliwal, Rupinder; Weitzel, Lindsay; Wischmeyer, Paul E.; Ochoa, Juan B.; Heyland, Daren K.

doi:10.1016/j.jamcollsurg.2010.10.016

Cited by 318 publications

(248 citation statements)

References 73 publications

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“…72 Due to the large number of small to medium size trials, many conclusions have been drawn from meta-analyses. In their landmark meta-analysis in 2011, Drover et al 73 demonstrated a 40% reduction in perioperative infectious complications with IMN. The effect observed in this analysis was similar whether the IMN was given preoperatively only, pre-and postoperatively, or postoperatively alone.…”

Section: Role Of Perioperative Imnmentioning

confidence: 99%

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway

Wischmeyer

Carli

Evans

et al. 2018

Anesthesia &Amp; Analgesia

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313

327

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Perioperative malnutrition has proven to be challenging to define, diagnose, and treat. Despite these challenges, it is well known that suboptimal nutritional status is a strong independent predictor of poor postoperative outcomes. Although perioperative caregivers consistently express recognition of the importance of nutrition screening and optimization in the perioperative period, implementation of evidence-based perioperative nutrition guidelines and pathways in the United States has been quite limited and needs to be addressed in surgery-focused recommendations. The second Perioperative Quality Initiative brought together a group of international experts with the objective of providing consensus recommendations on this important topic with the goal of (1) developing guidelines for screening of nutritional status to identify patients at risk for adverse outcomes due to malnutrition; (2) address optimal methods of providing nutritional support and optimizing nutrition status preoperatively; and (3) identifying when and how to optimize nutrition delivery in the postoperative period. Discussion led to strong recommendations for implementation of routine preoperative nutrition screening to identify patients in need of preoperative nutrition optimization. Postoperatively, nutrition delivery should be restarted immediately after surgery. The key role of oral nutrition supplements, enteral nutrition, and parenteral nutrition (implemented in that order) in most perioperative patients was advocated for with protein delivery being more important than total calorie delivery. Finally, the role of often-inadequate nutrition intake in the posthospital setting was discussed, and the role of postdischarge oral nutrition supplements was emphasized.

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Section: Role Of Perioperative Imnmentioning

confidence: 99%

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway

Wischmeyer

Carli

Evans

et al. 2018

Anesthesia &Amp; Analgesia

Self Cite

313

327

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“…79,80 These two reviews reported no harm in surgical patients. The Drover et al systematic review on perioperative supplementation of arginine (it included 35 trials) supports a significant treatment effect of arginine therapy following elective surgery.…”

Section: Glutamine (Cell-protective Nutrients)mentioning

confidence: 97%

“…The Drover et al systematic review on perioperative supplementation of arginine (it included 35 trials) supports a significant treatment effect of arginine therapy following elective surgery. 79 Arginine-supplemented diets were associated with considerably reduced overall infectious complications when compared with standard formula in surgical patients [28 …”

Section: Glutamine (Cell-protective Nutrients)mentioning

confidence: 99%

Immunonutrition: a South African perspective

Prins

Visser

2012

South African Journal of Clinical Nutrition

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“…Six major meta-analyses reviewing these trials in surgical and trauma patients have been published (64)(65)(66)(67)(68)(69) . The two most recent studies by Marik et al and Drover et al describe both substantial reduction in post-operative complications and a shorter LOS with the use of arginine administration.…”

Section: Arginine Supplementation In Surgical Patientsmentioning

confidence: 99%

Novel nutritional substrates in surgery

et al. 2013

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Pharmaco-nutrients have beneficial effects on protective and immunological mechanisms in patients undergoing surgery, which are important for recovery after injury and in combating infectious agents. The aim of this review article was to outline the potential of the administration of nutritional substrates to surgical patients and the underlying mechanisms that make them particularly important in peri-operative care. Surgery causes a stress response, which has catabolic effects on the body's substrate stores. The amino acid glutamine is a stimulating agent for immune cells. It activates protective mechanisms through its role as a precursor for antioxidants and it improves the barrier function of the gut. Arginine also enhances the function of the immune system, since it is the substrate for T-lymphocytes. Furthermore, n-3 PUFA stabilise surgery-induced hyper-inflammation. Taurine is another substrate that may counteract the negative effects of surgical injury on acid–base balance and osmotic balance. These pharmaco-nutrients rapidly become deficient under the influence of surgical stress. Supplementation of these nutrients in surgical patients may restore their protective and immune-enhancing actions and improve clinical outcome. Moreover, pre-operative fasting is still common practice in the Western world, although fasting has a negative effect on the patient's condition and the recovery after surgery. This may be counteracted by a simple intervention such as administering a carbohydrate-rich supplement just before surgery. In conclusion, there are various nutritional substrates that may be of great value in improving the condition of the surgical patient, which may be beneficial for post-operative recovery.

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Perioperative Use of Arginine-supplemented Diets: A Systematic Review of the Evidence

Cited by 318 publications

References 73 publications

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway

Immunonutrition: a South African perspective

Novel nutritional substrates in surgery

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