Early postoperative feeding--results of a North American survey

Early postoperative feeding (EPOF) practices among North American institutions were investigated using a survey questionnaire to obtain descriptive information regarding the overall utilization and criteria used to identify candidates for EPOF. EPOF was defined as the initiation of enteral nutrition support two to 48 hours postoperatively in major abdominal and thoracic surgical patients. Two hundred and ninety-seven questionnaires were mailed; 170 were completed. Sixty-nine (41%) institutions reported using EPOF. Feeding was initiated less than 12 hours postoperatively in 16% of centres; 84% reported EPOF 13-48 hours postoperatively. The majority (88%) of institutions did not have a specific nutritional guideline for determining which patients should receive EPOF. Objective and subjective nutritional indices, degree of preoperative malnutrition and type of surgery were considered by 23% of respondents when determining the need for EPOF. Percent weight loss, albumin and the anticipated postoperative NPO were considered the most reliable objective indices while decreased dietary intake, cachexic appearance and anorexia were considered the most reliable subjective indices. The results reveal that less than 50% of institutions surveyed use EPOF in major abdominal and thoracic surgical patients and the criteria used to identify candidates for EPOF were found to be variable.