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What's new in perioperative nutritional support?
1Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK.
Current Opinion in Anaesthesiology
|April 1, 2011
Summary
Optimizing perioperative nutrition is crucial for surgical patients. A multimodal pathway, including early screening and targeted nutritional support, can improve postoperative outcomes.
Area of Science:
- Surgical Nutrition
- Perioperative Medicine
- Clinical Review
Background:
- Malnutrition significantly impacts surgical outcomes, yet patient recognition remains inadequate.
- Existing nutritional interventions for surgical patients often suffer from poor study design and heterogeneity.
Purpose of the Study:
- To review recent developments in perioperative nutritional support.
- To examine the effects of malnutrition on surgical outcomes.
- To identify strategies for optimizing metabolic function and nutritional status pre- and postoperatively.
Main Methods:
- Systematic review of English language articles published between October 2008 and December 2010.
- Focus on clinically pertinent studies related to perioperative nutritional support.
Main Results:
- Despite available tools, identifying at-risk patients for malnutrition is insufficient.
- Multimodal pathways incorporating evidence-based interventions are recommended for elective surgery patients.
- Key interventions include nutritional screening, immuno-nutrition, preoperative conditioning, glutamine supplementation, and enhanced recovery protocols.
Conclusions:
- An evidence-based multimodal pathway for perioperative nutritional optimization may enhance outcomes in elective surgery.
- Early enteral feeding, supported by gut-specific nutrients and prokinetics, improves feed tolerance.
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