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Surgical nutrition: a review
C Saunders1, R Nishikawa, B Wolfe
1Department of Surgery, University of California, Davis, Medical Center, Sacramento 95817.
Journal of the Royal College of Surgeons of Edinburgh
|August 1, 1993
Summary
Critical illness drastically alters metabolism, affecting carbohydrates, lipids, and proteins. Nutritional support, including enteral and parenteral therapies, is crucial for managing these metabolic changes in critically injured patients.
Area of Science:
- Critical care medicine
- Human physiology
- Nutritional science
Background:
- Critical illness triggers complex metabolic responses impacting multiple organ systems.
- Altered metabolism of carbohydrates, lipids, and proteins is a hallmark of critical injury.
- Cytokine mediators like tumor necrosis factor (TNF), interleukins (ILs), and interferons (IFNs) play a key role.
Purpose of the Study:
- To detail the metabolic alterations in critically injured patients.
- To review nutritional support strategies, including enteral and parenteral therapies.
- To examine specialized amino acid and lipid formulations for metabolic modulation.
Main Methods:
- Review of existing literature on metabolic response to critical illness.
- Analysis of guidelines for nutritional support.
- Evaluation of research on specific nutrient formulations (glutamine, branched-chain amino acids, arginine, dietary lipids).
Main Results:
- Critical illness induces significant metabolic dysregulation.
- Enteral and parenteral nutrition offer distinct benefits and risks.
- Enriched amino acid and specific lipid formulations show potential for modulating immune and metabolic responses.
Conclusions:
- Integrated nutritional support is essential for managing critical illness.
- Tailored nutrient strategies can optimize metabolic and immune function.
- Further research is needed to fully elucidate the clinical impact of specialized nutritional interventions.