Appropriate use of parenteral nutrition through the perioperative period.

Stephen A. McClave, Robert Martindale, Beth Taylor, Leah Gramlich

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Recent advances in nutrition therapy of the patient undergoing elective surgery have focused on greater utilization of the gut, feeding closer to the time of surgery, avoiding extensive bowel preparations or use of nasogastric tubes and drains, and measures to promote and maintain intestinal motility. Failure to have protocols in place for delivery of enteral nutrition (EN) through the perioperative period should not lead to inappropriate use of parenteral nutrition (PN) as a default therapy, because in many circumstances, standard therapy with no specialized nutrition support may be associated with better outcome. In cases where EN is not feasible and the patient shows evidence of malnutrition, surgery should be delayed 7-10 days to provide perioperative PN. For patients requiring urgent surgery where EN is not feasible, the initiation of PN postoperatively should be delayed 5-7 days. Whether alternative sources for lipid emulsion and availability of parenteral immune-modulating agents in the future can improve the risk/benefit ratio of PN and expand its use through the perioperative period awaits further study.

Original languageEnglish (US)
JournalJPEN. Journal of parenteral and enteral nutrition
Volume37
Issue number5 Suppl
StatePublished - Sep 2013

Fingerprint

Perioperative Period
Parenteral Nutrition
Enteral Nutrition
Nutrition Therapy
Gastrointestinal Motility
Emulsions
Malnutrition
Odds Ratio
Lipids
Therapeutics

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Medicine(all)

Cite this

Appropriate use of parenteral nutrition through the perioperative period. / McClave, Stephen A.; Martindale, Robert; Taylor, Beth; Gramlich, Leah.

In: JPEN. Journal of parenteral and enteral nutrition, Vol. 37, No. 5 Suppl, 09.2013.

Research output: Contribution to journalArticle

@article{fd03b28e205b4ea68641f8416e2271ab,
title = "Appropriate use of parenteral nutrition through the perioperative period.",
abstract = "Recent advances in nutrition therapy of the patient undergoing elective surgery have focused on greater utilization of the gut, feeding closer to the time of surgery, avoiding extensive bowel preparations or use of nasogastric tubes and drains, and measures to promote and maintain intestinal motility. Failure to have protocols in place for delivery of enteral nutrition (EN) through the perioperative period should not lead to inappropriate use of parenteral nutrition (PN) as a default therapy, because in many circumstances, standard therapy with no specialized nutrition support may be associated with better outcome. In cases where EN is not feasible and the patient shows evidence of malnutrition, surgery should be delayed 7-10 days to provide perioperative PN. For patients requiring urgent surgery where EN is not feasible, the initiation of PN postoperatively should be delayed 5-7 days. Whether alternative sources for lipid emulsion and availability of parenteral immune-modulating agents in the future can improve the risk/benefit ratio of PN and expand its use through the perioperative period awaits further study.",
author = "McClave, {Stephen A.} and Robert Martindale and Beth Taylor and Leah Gramlich",
year = "2013",
month = "9",
language = "English (US)",
volume = "37",
journal = "Journal of Parenteral and Enteral Nutrition",
issn = "0148-6071",
publisher = "SAGE Publications Inc.",
number = "5 Suppl",

}

TY - JOUR

T1 - Appropriate use of parenteral nutrition through the perioperative period.

AU - McClave, Stephen A.

AU - Martindale, Robert

AU - Taylor, Beth

AU - Gramlich, Leah

PY - 2013/9

Y1 - 2013/9

N2 - Recent advances in nutrition therapy of the patient undergoing elective surgery have focused on greater utilization of the gut, feeding closer to the time of surgery, avoiding extensive bowel preparations or use of nasogastric tubes and drains, and measures to promote and maintain intestinal motility. Failure to have protocols in place for delivery of enteral nutrition (EN) through the perioperative period should not lead to inappropriate use of parenteral nutrition (PN) as a default therapy, because in many circumstances, standard therapy with no specialized nutrition support may be associated with better outcome. In cases where EN is not feasible and the patient shows evidence of malnutrition, surgery should be delayed 7-10 days to provide perioperative PN. For patients requiring urgent surgery where EN is not feasible, the initiation of PN postoperatively should be delayed 5-7 days. Whether alternative sources for lipid emulsion and availability of parenteral immune-modulating agents in the future can improve the risk/benefit ratio of PN and expand its use through the perioperative period awaits further study.

AB - Recent advances in nutrition therapy of the patient undergoing elective surgery have focused on greater utilization of the gut, feeding closer to the time of surgery, avoiding extensive bowel preparations or use of nasogastric tubes and drains, and measures to promote and maintain intestinal motility. Failure to have protocols in place for delivery of enteral nutrition (EN) through the perioperative period should not lead to inappropriate use of parenteral nutrition (PN) as a default therapy, because in many circumstances, standard therapy with no specialized nutrition support may be associated with better outcome. In cases where EN is not feasible and the patient shows evidence of malnutrition, surgery should be delayed 7-10 days to provide perioperative PN. For patients requiring urgent surgery where EN is not feasible, the initiation of PN postoperatively should be delayed 5-7 days. Whether alternative sources for lipid emulsion and availability of parenteral immune-modulating agents in the future can improve the risk/benefit ratio of PN and expand its use through the perioperative period awaits further study.

UR - http://www.scopus.com/inward/record.url?scp=84898140293&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84898140293&partnerID=8YFLogxK

M3 - Article

VL - 37

JO - Journal of Parenteral and Enteral Nutrition

JF - Journal of Parenteral and Enteral Nutrition

SN - 0148-6071

IS - 5 Suppl

ER -