Nutritional support of the surgical patient

Malnutrition, unfortunately, is not uncommon and malnourished patients suffer increased morbidity and mortality from surgery. Identification of protein-calorie deficient patients can be performed rapidly and inexpensively through standard techniques of nutritional assessment. If the gastrointestinal tract is available, safe and economic nutritional support may be provided by mouth or by tube feeding. If the gastrointestinal tract cannot be utilized, total parenteral nutrition (TPN) may be instituted via a central vein, or in selected instances peripheral amino acids, fat emulsions, or both may suffice. When failure of various organs (heart, kidneys, liver) complicates malnutrition and the underlying surgical condition, adequate nutritional support can and should be provided by adjustment of the amount and content of commercially available nutritional formulations. Optimal surgical care demands the identification and appropriate nutritional support of malnourished patients.