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Related Experiment Videos

Perioperative nutritional support: a randomised clinical trial.

M F Von Meyenfeldt1, W J Meijerink, M M Rouflart

  • 1Department of Surgery, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands.

Clinical Nutrition (Edinburgh, Scotland)
|August 1, 1992
PubMed
Summary

Pre-operative nutritional support, including total parenteral nutrition (TPN) and total enteral nutrition (TEN), significantly reduces major complications in severely depleted surgical patients. This intervention is recommended for routine use in this high-risk group.

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Area of Science:

  • Surgical Nutrition
  • Critical Care Medicine
  • Metabolic Support

Background:

  • Artificial nutritional support aims to reduce surgical patient mortality and morbidity.
  • Previous trials often flawed, yielding inconclusive results.
  • Severe depletion is a significant risk factor for postoperative complications.

Purpose of the Study:

  • To investigate the efficacy of pre-operative total parenteral nutrition (TPN) and total enteral nutrition (TEN) in reducing major postoperative complications and mortality.
  • To assess the impact of nutritional support in a homogeneous group of depleted surgical patients.
  • To compare outcomes between nutritional support groups, a depleted control group, and a non-depleted reference group.

Main Methods:

  • Prospective randomized trial comparing TPN (n=51) and TEN (n=50) for at least 10 days pre-operatively.

Related Experiment Videos

  • Nutritional support provided 150% of basal energy expenditure (BEE) non-protein energy.
  • Control groups included depleted (D, n=50) and non-depleted (ND, n=49) patients without immediate nutritional intervention.

    • Main Results:

    • Depleted control patients experienced significantly more septic complications than non-depleted patients (p < 0.05).
    • No significant difference in septic complications between nutritional support groups and the non-depleted control group.
    • Nutritional support significantly decreased major complications in high-risk patients (weight loss >10%, blood loss >500 ml) (p < 0.05).

    Conclusions:

    • Pre-operative nutritional support effectively reduces major complications in severely depleted surgical patients.
    • The observed reduction in complications justifies the routine use of nutritional support in this selected patient population.
    • Targeted nutritional intervention is crucial for improving outcomes in high-risk surgical candidates.