[Perioperative nutrition in ERAS Protocols]

Area of Science:

• Metabolic stress response
• Surgical outcomes
• Nutritional science

Background:

• Surgical procedures induce a metabolic stress response, leading to postoperative insulin resistance (PIR).
• PIR is a marker for increased surgical morbidity and prolonged hospital stays.
• Prolonged preoperative fasting and delayed postoperative feeding exacerbate PIR.

Purpose of the Study:

• To evaluate the role of Enhanced Recovery After Surgery (ERAS) protocols in modulating PIR.
• To assess the impact of perioperative nutritional interventions within ERAS on patient recovery.
• To highlight the importance of optimizing perioperative nutrition for surgical patients.

Main Methods:

• Review of ERAS protocols focusing on anesthetic, surgical, kinesiology, nutritional, and nursing interventions.
• Analysis of perioperative nutritional strategies, including oral carbohydrate loading and early postoperative feeding.
• Examination of the safety and efficacy of these interventions, particularly in patients with type 2 diabetes.

Main Results:

• ERAS protocols aim to modulate PIR through comprehensive interventions.
• Nutritional strategies like preoperative carbohydrate loading and early feeding are effective in reducing complications and length of stay.
• These interventions are safe and beneficial even for well-controlled type 2 diabetes patients.

Conclusions:

• Perioperative nutritional interventions within ERAS protocols are effective in reducing postoperative insulin resistance and improving patient recovery.
• Despite proven benefits, the implementation and compliance with these ERAS nutritional guidelines are currently low.
• Continued efforts are needed to enhance perioperative nutritional management for optimal surgical outcomes.