MALNUTRITION IN THE SURGICAL PATIENTS

Biljana Jordan Andonovska, Biljana Kojce Kuzmanovska, Alan Goce Andonovski, Andrijan Borislav Kartalov, Dragana Krume Petrovska-Cvetkovska

Abstract


The term "malnutrition" is a broad term used to describe any imbalance in the diet. In 2009 it was confirmed that malnutrition is an urgent health problem. The reasons for which malnutrition may develop are different. Loss on cellular, physical and physiological level happens as a consequence of malnutrition. Studies show that in surgical practice there is malnutrition in 50% of patients and that there is a association between inadequate nutritional status and surgical result. It leads to prolonged treatment, increasing of the level of morbidity and mortality, increased hospital costs, etc. Sometimes malnutrition is unrecognised, untreated and worsened in hospitals. For this reason this paper will elaborate: nutrition and a surgical patient, assessment of a nutritional status, assessment of energy requirements, and enteral and parenteral nutrition in order to determine the conditions and procedures that affect the appearance, recognition and treatment of malnutrition.


Keywords


malnutrition, surgical patient, nutritional assessment, assessment of energy requirements, enteral nutrition, parenteral nutrition.

Full Text:

PDF

References


Naber TH, Schermer T, deBree A, et al. Prevalence of malnutrition in nonsurgical hospitalized patients and its association with disease complications. Am J Clin Nutr. 1997; 66(5):1232–9.

Holmes S. The effects of undernutrition in hospitalised patients. Nurs Stand. 2007; 22(12):35–8.

Waitzberg DL, Ravacci GR, Raslan M. Hospital hyponutrition. Nutr Hosp. 2011; 26(2):254–64.

STOP Disease-related Malnutrition: Prague Declaration June 2009 ENHA joins with the Czech Presidency of the EU Date: 22 June 2009

Jensen GL. Inflammation as the key interface of the medical and nutrition universes: a provocative examination of the future of clinical nutrition and medicine. J Parenter Enteral Nutr. 2006; 30(5):453-63.

Thorell A, Nygren J, Ljungqvist O. ?nsulin resistance: a marker of surgical stress. Curr Opin Clin Nutr Metab Care. 1999;2(1):69–78.

Fearon KC, Ljungqvist O, Von Meyenfeldt M, et al.Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection.Clin Nutr. 2005; 24(3): 466–77.

Strunin, L. How long should the patient fast before surgery? Time for new guidelines. Br J Anaesth.1993; 70(1):1–3.

Green CR, Pandit SK, Schork MA. Preoperative fasting time: is the traditional policy changing? Results of a national survey. Anaesth Analg.1996; 83(1): 123–8.

Zeli? M, Stimac D, Mendrila D, et al. Influence of preoperative oral feeding on stress response after resection for colon cancer. Hepatogastroenterology. 2012;59(117): 1385-9.

El Nakeeb A, Fikry A, El Metwally T, et al. Early oral feeding in patients undergoing elective colonic anastomosis. Int J Surg. 2009; 7(3):206–9.

Lewis SJ, Egger M, Sylvester PA, Thomas S. Early enteral feeding versus “nil by mouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ. 2001;323(7316):773–6.

Andersen HK, Lewis SJ, Thomas S. Early enteral nutrition within 24h of colorectal surgery versus later commencement of feeding for postoperative complications. Cochrane Database Syst Rev. 2006;4:CD004080.

Lewis SJ, Andersen HK, Thomas S. Early enteral nutrition within 24 h of intestinal surgery versus later commencement of feeding: a systematic review and meta-analysis. J Gastrointest Surg. 2009;13(3):569–75.

Drover JW, Cahill NE, Kutsogiannis J, et al. Nutrition therapy for the critically ill surgery patient: we need to do better!J Parenter Enteral Nutri. 2010; 34(6):644-52.

Correia MI, Campos AC, ELAN Cooperative Study. Prevalence of hospital malnutrition in Latin America: the multicenter ELAN study. Nutrition. 2003;19(10):823-5.

Mueller C, Compher C, Ellen DM. A.S.P.E.N. clinical guidelines: nutrition screening, assessment and intervention in adults. J Parenter Enteral Nutri. 2011; 35(1):16-24.

Blackburn GL, Bistrian BR, Maini BS, Schlamm HT, Smith MF. Nutritional and metabolic assessment of the hospitalized patient. J Parenter Enteral Nutr. 1977;1(1):11-21.

Dewys WD, Begg C, Lavin PT, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med. 1980; 69(4): 491-7.

Meguid MM, Debonis D, Meguid V, Hill LR, Terz JJ. Complications of abdominal operations for malignant disease. Am J Surg. 1988; 156(5):341- 5.

Meguid MM, Campos ACL, Meguid V, Debonis D, Terz JJ. IONIP, a criterion of surgical outcome and patient selection for perioperative nutritional support. Br J Clin Pract Suppl. 1988;63:8- 14.

Klidjian AM, Foster KJ, Kammerling RM, Cooper A, Karran SJ. Relation of anthropometric and dynamometric variables to serious post-operative complications. Br Med J. 1980; 281(6245):899- 901.

Sungurtekin H, Sungurtekin U, Balci C, Zencir M, Erdem E. The influence of nutritional status on complications after major intraabdominal surgery. J Am Coll Nutr. 2004;23(3): 227–32.

Detsky AS, Baker JP, O'Rourke K, et al. Predicting nutrition-associated complications for patients undergoing gastrointestinal surgery. J Parenter Enteral Nutr. 1987;11(5): 440-6.

Gheorghe C, Pascu O, Iacob R, et al. Nutritional risk screening and prevalence of malnutrition on admission to gastroenterology departments: a multicentric study. Chirurgia (Bucur) 2013;108(4):535-41.

Rodriguez Bugueiro J, Lacquaniti N, Merkel MC, Villagra A. Active nutrition policy in the implementation of the hospital nutritional support; results of an observational study. Nutr Hosp. 2014;30(2):447-52.

Fuhrman MP, Charney P, Mueller CM. Hepatic proteins and nutrition assessment. J Am Diet Assoc. 2004;104(8):1258-64.

Jie B, Jiang ZM, Nolan MT, Zhu SN, Yu K, Kondrup J. Impact of preoperative nutritional support on clinical outcome in abdominal surgical patients at nutritional risk. Nutrition. 2012; 28(10):1022-7.

Long CL, Schaffel N, Geiger JW, Schiller WR, Blakemore WS. Metabolic response to injury and illness: Estimation of energy and protein needs from indirect calorimetry and nitrogen balance. J Parent Enteral Nutr.1979; 3(6): 452–6.

Doley J, Mallampalli A, Sandberg M. Nutrition management for the patient requiring prolonged mechanical ventilation. Nutr Clin Pract. 2011;26(3):232-41.

Cerra FB, Benitez MR, Blackburn GL, et al. Applied nutrition in ICU patients: a consensus statement of the American College of Chest Physicians. Chest. 1997;111(3):769-78.

MacDonald A, Hildebrandt L.Comparison of formulaic equations to determine energy expenditure in the critically ill patient. Nutrition. 2003;19(3): 233-9.

Harris JA, Benedict FG. A biometric study of basal metabolism in man. Washington, DC: Carnegie Institute of Washington; 1919.

Krenitsky J. Adjusted body weight, pro: evidence to support the use of adjusted body weight in calculating calorie requirements. Nutr Clin Pract. 2005;20(4):468-73.

Haugen HA, Chan LN, Li F. Indirect calorimetry: a practical guide for clinicians. Nutr Clin Pract. 2007;22(4): 377-88.

McClave SA, Lowen CC, Kleber MJ, McConnell W, Jung LY, Goldsmith LJ. Clinical use of the respiratory quotient obtained from indirect calorimetry. J Parenter Enteral Nutr. 2003;27(1): 21-6.

Stapel SN, de Grooth HJ, Alimohamad H, et al. Ventilator derived carbon-dioxide production to assess energy expenditure in critically ill patients: proof of concept. Crit Care. 2015;19:370. doi: 10.1186/s13054-015-1087-2.

Wooley JA, Sax HC. Indirect calorimetry: applications to practice. Nutr Clin Pract. 2003;18(5): 434-9.

Weimann A, Braga M, Harsanyi L, et al. ESPEN guidelines on enteral nutrition: surgery including organ transplantation. Clin Nutr. 2006;25(2):224–44.

Sandstrom R, Drott C, Hyltander A,et al. The effect of postoperative intravenous feeding (TPN) on outcome following major surgery evaluated in a randomized study. Ann Surg. 1993;217(2):185–95.

Von Meyenfeldt MF, Meijerink WJ, Roufflart MM, Builmaassen MT, Soeters PB. Perioperative nutritional support: a randomized clinical trial.Clin Nutr. 1992; 11(4):180–6.

Crowe PJ, Dennison A, Royle GT. The effect of pre-operative glucose loading on postoperative nitrogen metabolism. Br J Surg. 1984;71(8):635–7.

Druml W. Nutritional management of acute renal failure.Am J Kidney Dis. 2001; 37(Suppl.2):S89–94.

Machado De Sousa LR, Rodriques Ferreira SM, Madalozzo Schieferdecker ME. Physicochemical and nutricional characteristics of handmade enteral diets. Nutr Hosp. 2014;29(3):568–74.

Braga M, Gianotti L, Radaelli G, et al. Perioperative immunonutrition in patients undergoing cancer surgery: results of a randomized double-blind phase 3 trial. Arch Surg. 1999;134(4):428-33.

Senkal M, Mumme A, Eickhoff U, et al. Early postoperative enteral immunonutrition: clinical outcome and cost-comparison analysis in surgical patients. Crit Care Med. 1997;25(9):1489-96.

Braunschweig CL, Levy P, Sheean PM, Wang X. Enteral compared with parenteral nutrition: a meta-analysis. Am J Clin Nutr. 2001;74(4):534-42.

Payne-James J., Grimble G., Silk D. Artificial Nutrition Support in Clinical Practice. Greenwich Medical Media Ltd 2001.

Lowry SF. The route of feeding influences injury responses. J Trauma. 1990; 30(12 suppl): S10–5.

Lipman TO. Grains or veins: is enteral nutrition really better than parenteral nutrition?

A look at the evidence. J Parenter Enteral Nutr. 1998;22(3):167- 82.

Jie B, Jiang ZM, Nolan MT, et al. Impact of nutritional support on clinical outcome in patients at nutritional risk: a multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals. Nutrition. 2010; 26(11-12): 1088–93.

Heidegger CP, Romand JA, Treggiari MM, Pichard C. Is it now time to promote mixed enteral and parenteral nutrition for the critically ill patients? Intensive Care Med. 2007; 33(6):963-9.

Casaer MP, Mesotten D, Hermans G, et al. Early versus late parenteral nutrition in critically ill adults. N Engl J Med. 2011;365(6):506-17.

Hsu MH, Yu YE, Tsai YM, Lee HC, Huang YC, Hsu HS. Combined enteral feeding and total parenteral nutritional support improves outcome in surgical intensive care unit patients J Chin Med Assoc. 2012; 75(9):459–63.




DOI: http://dx.doi.org/10.24125/sanamed.v11i3.127

Refbacks

  • There are currently no refbacks.


Copyright (c) 2016 authors

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.