ESPEN guideline: Clinical nutrition in surgeryShow others and affiliations
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
Keyword [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
2017-06-092017-06-092017-09-18Bibliographically approved