Daniel A de Luis1, Jesus M Culebras2, Rocio Aller1, Jose María Eiros-Bouza3. 1. School of Medicine and Research Unit, Institute of Endocrinology and Nutrition, Hospital Rio Hortega, University of Valladolid. Valladolid. Spain.. Jesus@culebras.eu. 2. Member of the Royal Academy of Medicine and Surgery of Valladolid. and of the Institute of Biomedicine (IBIOMED) of the University of Leon. External Member of the Institute of Biochemical Research, Fundacion Jimenez Diaz University Hospital, Madrid, Spain.. Jesus@culebras.eu. 3. Department of Microbiology. Hospital Rio Hortega, University of Valladolid. Valladolid. Spain.. Jesus@culebras.eu.
Abstract
BACKGROUND: Malnutrition in surgical patients is associated with delayed recovery, higher rates of morbidity and mortality, prolonged hospital stay, increased healthcare costs and a higher early re-admission rate. METHODS: Data synthesis after review of pertinent literature. RESULTS: The aetiology of malnutrition is multifactorial. In cancer patients, there is an abnormal peripheral glucose disposal, gluconeogenesis, and whole-body glucose turnover. Malnourished cancer patients undergoing major operations are at significant risk from perioperative complications such as infectious complications. Surgical aggression generates an inflammatory response which worsens intermediary metabolism. CONCLUSIONS: Nutritional evaluation and nutritional support must be performed in all surgical patients, in order to minimize infectious complications. Enteral nutrition early in the postoperative period is effective and well tolerated reducing infectious complications, improving wound healing and reducing length of hospital stay. Pharmaconutrition is indicated in those patients, who benefit from enteral administration of arginine, omega 3 and RNA, as well as parenteral glutamine supplementation. When proximal sutures are used, tubes allowing early jejunal feeding should be used. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
BACKGROUND:Malnutrition in surgical patients is associated with delayed recovery, higher rates of morbidity and mortality, prolonged hospital stay, increased healthcare costs and a higher early re-admission rate. METHODS: Data synthesis after review of pertinent literature. RESULTS: The aetiology of malnutrition is multifactorial. In cancerpatients, there is an abnormal peripheral glucose disposal, gluconeogenesis, and whole-body glucose turnover. Malnourished cancerpatients undergoing major operations are at significant risk from perioperative complications such as infectious complications. Surgical aggression generates an inflammatory response which worsens intermediary metabolism. CONCLUSIONS: Nutritional evaluation and nutritional support must be performed in all surgical patients, in order to minimize infectious complications. Enteral nutrition early in the postoperative period is effective and well tolerated reducing infectious complications, improving wound healing and reducing length of hospital stay. Pharmaconutrition is indicated in those patients, who benefit from enteral administration of arginine, omega 3 and RNA, as well as parenteral glutamine supplementation. When proximal sutures are used, tubes allowing early jejunal feeding should be used. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Authors: Khalid M Bhatti; Zainab N Al-Balushi; Mahmoud H Sherif; Sareyah M Al-Sibai; Ashfaq A Khan; Mazen A Mohammed; Maria F Batacalan; Cheryl C Montemayor; Mohammad Fazalullah; Masood Ahmed; Mathew Kripail; Asad Ur-Rahman; Zenaida Reyes; Mohamed Abdellatif Journal: Sultan Qaboos Univ Med J Date: 2015-01-21
Authors: Maurizio Cardi; Simone Sibio; Francesco Di Marzo; Francesco Lefoche; Claudia d'Agostino; Giovanni Battista Fonsi; Giuseppe La Torre; Ludovica Carbonari; Paolo Sammartino Journal: Gastroenterol Res Pract Date: 2019-05-02 Impact factor: 2.260
Authors: F Di Gennaro; C Marotta; L Pisani; N Veronese; V Pisani; V Lippolis; G Pellizer; D Pizzol; F Tognon; D F Bavaro; F Oliva; S Ponte; P Nanka Bruce; L Monno; A Saracino; M M Koroma; G Putoto Journal: Epidemiol Infect Date: 2020-02-27 Impact factor: 2.451