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[Consequences of surgery on nutritional status]

R Chioléro1

  • 1Département Anesthésiologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Suisse.

Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1995
PubMed
Summary

Trauma and surgery trigger the acute phase reaction (APR), causing metabolic changes and resistance to nutrition. Early enteral nutrition and regional anesthesia may mitigate these effects in surgical and trauma patients.

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Area of Science:

  • Physiology
  • Metabolism
  • Immunology

Context:

  • Trauma and surgery initiate a complex physiological response known as the acute phase reaction (APR).
  • The APR involves hormonal shifts, metabolic alterations, and the production of acute-phase proteins.
  • Stimuli include pain, tissue damage, ischemia-reperfusion, and hemodynamic instability.

Purpose:

  • To describe the physiological changes during the acute phase reaction (APR) following trauma and surgery.
  • To outline the metabolic consequences and impact on nutritional support.
  • To explore potential interventions like enteral nutrition and regional anesthesia.

Summary:

  • The acute phase reaction (APR) is characterized by counter-regulatory hormones, metabolic shifts, and hepatic synthesis of acute-phase factors, often accompanied by fever and nutritional resistance.
  • APR intensity varies with surgical extent, complications, and patient factors; minor trauma requires no nutritional support, while major trauma leads to significant catabolism and cell mass loss.
  • Early enteral nutrition and regional anesthesia show promise in mitigating the endocrine and metabolic responses associated with APR in surgical and trauma patients.

Impact:

  • Understanding APR is crucial for managing surgical and trauma patients, particularly regarding nutritional strategies.
  • Early enteral nutrition may improve outcomes by counteracting the catabolic effects of APR.
  • Regional anesthesia offers a potential adjunctive therapy to reduce the severity of the acute phase response.

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