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ESPEN guideline: Clinical nutrition in surgery
Klinik für Allgemein-, Viszeral- und Onkologische Chirurgie, Klinikum St. Georg gGmbH, Leipzig, Germany.
San Raffaele Hospital, Milan, Italy.
Department of Anesthesia, School of Nutrition, Montreal General Hospital, McGill University, Montreal, Canada.
Department of Surgery & Palliative Medicine, Fujita Health University School of Medicine, Toyoake, Japan.
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2017 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 36, no 3, p. 623-650Article in journal (Refereed) Published
Abstract [en]

Early oral feeding is the preferred mode of nutrition for surgical patients. Avoidanc'e of any nutritional therapy bears the risk of underfeeding during the postoperative course after major surgery. Considering that malnutrition and underfeeding are risk factors for postoperative complications, early enteral feeding is especially relevant for any surgical patient at nutritional risk, especially for those undergoing upper gastrointestinal surgery. The focus of this guideline is to cover nutritional aspects of the Enhanced Recovery After Surgery (ERAS) concept and the special nutritional needs of patients undergoing major surgery, e.g. for cancer, and of those developing severe complications despite best perioperative care. From a metabolic and nutritional point of view, the key aspects of perioperative care include:

integration of nutrition into the overall management of the patient

avoidance of long periods of preoperative fasting

re-establishment of oral feeding as early as possible after surgery

start of nutritional therapy early, as soon as a nutritional risk becomes apparent

metabolic control e.g. of blood glucose

reduction of factors which exacerbate stress-related catabolism or impair gastrointestinal function

minimized time on paralytic agents for ventilator management in the postoperative period

early mobilisation to facilitate protein synthesis and muscle function The guideline presents 37 recommendations for clinical practice.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 36, no 3, p. 623-650
Keywords [en]
Surgery, ERAS, Perioperative nutrition, Enteral nutrition, Parenteral nutrition, Prehabilitation
National Category
Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:oru:diva-57903DOI: 10.1016/j.clnu.2017.02.013ISI: 000401208700001PubMedID: 28385477OAI: oai:DiVA.org:oru-57903DiVA, id: diva2:1107459
Available from: 2017-06-09 Created: 2017-06-09 Last updated: 2018-09-14Bibliographically approved

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Ljungqvist, Olle

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