Extending the benefit of nutrition intervention beyond the operative setting

预热 围手术期 肌萎缩 医学 心理干预 重症监护医学 模式治疗法 营养过剩 干预(咨询) 营养补充 医学营养疗法 物理疗法 外科 营养不良 内科学 护理部
作者
Paulo Luiz Batista Nogueira,Diana Borges Dock‐Nascimento,José Eduardo de Aguilar‐Nascimento
出处
期刊:Current Opinion in Clinical Nutrition and Metabolic Care [Lippincott Williams & Wilkins]
卷期号:25 (6): 388-392 被引量:4
标识
DOI:10.1097/mco.0000000000000868
摘要

To provide an update of the recent evidence on the potential of perioperative nutritional interventions to benefit adult patients undergoing head and neck and digestive procedures.Perioperative nutrition within multimodal prehabilitation programs improve postoperative outcomes. Perioperative fasting time can be reduced with beverages containing carbohydrate alone or blended with a nitrogenous source such as whey protein; this approach seems to be safe and improve outcome. The choice of protein-containing formula, as well as diet composition to be recommended early during the postoperative refeeding, can be optimized to reduce complications. Sarcopenia is an important risk factor for surgical patients, as such, prehabilitation along with preoperative nutrition is strongly advised. Perioperative supplementation with β-hydroxy β-methylbutyrate to mitigate sarcopenia requires further investigation. Although perioperative nutritional interventions reduce healthcare costs, recent data suggest it has been scarcely prescribed.Nutritional intervention is key in multimodal programs of enhanced recovery after surgery to ensure better outcomes. Perioperative fasting should be shortened, and include clear fluids containing carbohydrates and protein, especially in the early postoperative period. Multimodal prehabilitation is key to mitigate sarcopenia. Action to improve knowledge on the cost-effectiveness of nutritional interventions in the perioperative setting are needed.

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