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Nutritional support.There is some evidence that immunonutrition, the ingestion of amino acids (e.g. glutamine and arginine), omega-3 fatty acids, and nucleotides counteracts the hyper inflammation and immune impairment caused by the surgical stress response, promoting wound healing, reducing infection rates, and shortening length of stay.The European Society for Clinical Nutrition and Metabolism recommends a daily protein intake of 1.5 g kg_1 ideal body weight in surgical patients to limit nitrogen losses--double the normal daily requirement.It is clear from the literature that poor nutritional status is associated with poor postoperative
outcomes; length of stay, infectious complications, readmission rates, and mortality are all adversely affected.Whey protein is under consideration as a high-quality, highly bioavailable source of essential amino acids.
Nutritional support.
It is clear from the literature that poor nutritional status is associated with poor postoperative
outcomes; length of stay, infectious complications, readmission rates, and mortality are all adversely affected. Pre-existing nutritional status, severity of the surgical insult, and the nature of the surgery (e.g. major gastrointestinal resection) all contribute to nutrition risk. Episodes of starvation during the perioperative period only serve to exacerbate the problem. Formal screening for nutrition risk should take place before any major surgery, and malnourished patients should receive 7–10 days of ideally enteral nutritional support preoperatively.
Interventions include preoperative carbohydrate loading, which reduces insulin resistance and promotes an anabolic state, minimizing loss of protein, lean body mass, and muscle function. Taken a few hours before exercise, carbohydrates increase liver and muscle glycogen and facilitate completion of the exercise session.
The European Society for Clinical Nutrition and Metabolism recommends a daily protein intake of 1.5 g kg_1 ideal body weight in surgical patients to limit nitrogen losses—double the normal daily requirement. Whey protein is under consideration as a high-quality, highly bioavailable source of essential amino acids.
There is some evidence that immunonutrition, the ingestion of amino acids (e.g. glutamine and arginine), omega-3 fatty acids, and nucleotides counteracts the hyper inflammation and immune impairment caused by the surgical stress response, promoting wound healing, reducing infection rates, and shortening length of stay. Such a regime is optimally commenced 5–7 days before operation and should be continued for a similar period after operation in the malnourished.
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