Nutrition Optimization Prior to Surgery

David C. Evans, Robert Martindale, Laszlo N. Kiraly, Christopher M. Jones

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Optimization of metabolic state prior to major surgery leads to improved surgical outcomes. Nutrition screening protocols should be implemented in the preoperative evaluation, possibly as part of a bundle. Strategies to minimize hyperglycemia and insulin resistance by aggressive preoperative nutrition and carbohydrate loading may promote maintenance of a perioperative anabolic state, improving healing, reducing complications, and shortening the time to recovery of bowel function and hospital discharge. Short courses of preoperative immune-modulating formulas, using combinations of arginine, ω-3 fatty acids, and other nutrients, have been associated with improved surgical outcomes. These immune-modulating nutrients are key elements of metabolic pathways that promote attenuation of the metabolic response to stress and improve both wound healing and immune function. Patients with severe malnutrition and gastrointestinal dysfunction may benefit from preoperative parenteral nutrition. Continuation of feeding through the intraoperative period for severely stressed hypermetabolic patients undergoing nongastrointestinal surgery is another strategy to optimize metabolic state and reduce prolonged nutrition deficits. In this paper, we review the importance of preoperative nutrition and strategies for effective preoperative nutrition optimization.

Original languageEnglish (US)
Pages (from-to)10-21
Number of pages12
JournalNutrition in Clinical Practice
Volume29
Issue number1
DOIs
StatePublished - Feb 2014

Fingerprint

Intraoperative Period
Food
Physiological Stress
Recovery of Function
Parenteral Nutrition
Metabolic Networks and Pathways
Malnutrition
Hyperglycemia
Wound Healing
Arginine
Insulin Resistance
Fatty Acids
Maintenance
Carbohydrate Loading Diet

Keywords

  • enteral nutrition
  • nutrition assessment
  • nutritional support
  • parenteral nutrition
  • preoperative care
  • preoperative period
  • surgery

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Nutrition Optimization Prior to Surgery. / Evans, David C.; Martindale, Robert; Kiraly, Laszlo N.; Jones, Christopher M.

In: Nutrition in Clinical Practice, Vol. 29, No. 1, 02.2014, p. 10-21.

Research output: Contribution to journalArticle

Evans, David C. ; Martindale, Robert ; Kiraly, Laszlo N. ; Jones, Christopher M. / Nutrition Optimization Prior to Surgery. In: Nutrition in Clinical Practice. 2014 ; Vol. 29, No. 1. pp. 10-21.
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