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Nutritional support in surgical practice: Part II.

M M Meguid1, A C Campos, W G Hammond

  • 1Department of Surgery, State University of New York Health Science Center, Syracuse 13210.

American Journal of Surgery
|April 1, 1990
PubMed
Summary
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Prompt nutritional support for high-risk surgical patients, including those with inflammatory bowel disease or organ failure, can improve outcomes. Early intervention optimizes host defenses and aids recovery, regardless of initial nutritional status.

Area of Science:

  • Clinical Nutrition
  • Surgical Critical Care

Background:

  • High-risk surgical patients often benefit from nutritional support.
  • Conditions like inflammatory bowel disease, gastrointestinal fistulas, and pancreatitis necessitate careful management.
  • Organ system failures (renal, liver, pulmonary) present unique metabolic challenges.

Purpose of the Study:

  • To review the role of preoperative enteral or parenteral nutrition in high-risk surgical patients.
  • To evaluate the impact of nutritional support on morbidity and mortality.
  • To assess the benefits of nutritional intervention in patients with organ system failures.

Main Methods:

  • Review of existing literature on nutritional support in surgical and critically ill patients.
  • Analysis of patient populations including those with specific gastrointestinal diseases and organ failures.

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  • Evaluation of the effects of nutritional intervention on host defenses and metabolic processes.

    • Main Results:

    • Prompt initiation of preoperative enteral or parenteral nutrition may reduce postoperative morbidity and mortality in identified high-risk groups.
    • Nutritional support optimizes host defenses for healing, irrespective of initial nutritional status.
    • In organ system failures, nutritional support aids in managing abnormal metabolism until organ function returns.

    Conclusions:

    • Early nutritional intervention is crucial for high-risk surgical patients.
    • Correcting malnutrition before or during treatment significantly improves a patient's ability to withstand severe illness and therapy.
    • Nutritional support plays a vital role in recovery from critical illness and organ system failure.