[Perioperative nutritional supplementation-what is really evidence based?]

Area of Science:

• Surgical nutrition
• Perioperative medicine
• Metabolic risk assessment

Background:

• Early recovery after surgery (ERAS) protocols emphasize early oral feeding post-major surgery.
• Traditional perioperative nutritional support is increasingly viewed as outdated.
• Malnutrition and sarcopenia prevalence remains significant, even in overweight/obese populations.

Purpose of the Study:

• To review current concepts in perioperative nutritional supplementation.
• To discuss evidence and guideline recommendations for nutritional therapy in surgical patients.
• To highlight the importance of identifying patients at metabolic risk.

Main Methods:

• Literature review of current perioperative nutritional concepts.
• Analysis of evidence supporting nutritional supplementation.
• Examination of existing guideline recommendations.

Main Results:

• ERAS protocols are the standard for major surgery, focusing on early oral intake.
• Despite ERAS, a notable prevalence of malnutrition/sarcopenia exists, requiring metabolic risk assessment.
• Nutritional therapy indications and current supplementation strategies require careful consideration.

Conclusions:

• Perioperative nutritional support remains relevant for specific patient groups identified at metabolic risk.
• Evidence and guidelines for nutritional therapy need to be integrated into modern surgical care.
• A balanced approach is needed, considering both ERAS principles and the risk of malnutrition.