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Preoperative and perioperative nutrition and nutritional treatment

Publication at First Faculty of Medicine |
2018

Abstract

Assessing the nutritional status of the patient (nutritional screening and examination) and nutritional support during the perioperative period have a significant effect on the overall outcome of surgical performance, especially in risk patients (geriatric and oncological patients, patients with non-specific intestinal inflammation or chronic catabolic disease). Enhanced recovery of patients after surgery (ERAS) is one of the major goals of perioperative care.

From the metabolic and nutritional point of view, it is crucial to avoid long-term fasting before surgery, to restore oral intake as soon as possible, to integrate nutrition into total patient care, to reduce catabolism or damaging gastrointestinal factors, metabolic control (e.g. glucose correction) and early mobilization. Ceneral indications for nutritional support in surgery are the prevention and treatment of malnutrition, it means correction of malnutrition before surgery and maintenance of the nutritional status after surgery, where prolonged starvation and / or severe catabolism is expected.

Morbidity, length of hospitalization and mortality are considered to be the main outcome parameters evaluating the benefit of nutritional support. In the case of palliative care, the main criteria are improving the nutritional status and quality of life.

In the next part of the article, there are listed procedures of nutritional examination and intervention before surgery in specific types of patients and in the end a case report of a Crohn's disease patient undergoing surgery.