Perioperative nutritional support

J. Askanazi, C. Weissman, Michael Rothkopf, P. M. Starker

Research output: Contribution to journalArticle

Abstract

The relationship between nutritional status and postoperative morbidity and mortality is well known, leading many investigators to explore whether preoperative nutritional support can decrease morbidity and mortality. Our own series of studies demonstrate an important relation between preoperative parenteral nutrition and morbidity and mortality, which can be summarized as follows: preoperative nutrition can reduce postoperative complications; such a reduction in complications is directly related to serum albumin status; a rise in serum albumin represents and correlates with a normalization of body composition. A recent retrospective study on the effect of nutritional support on duration of hospitalization demonstrated that immediate postoperative parenteral nutrition results in a reduction in hospitalization time in patients with no significant degree of preoperative malnutrition. It appears that the decreased hospitalization time in the group receiving early aggressive nutritional therapy was not due to individual, clearly identifiable factors (e.g., improved wound healing); instead, it seemed that the D5W group had a slower convalescence with a decreased rate of return of postoperative activity. The metabolic pattern observed in stress, unlike that seen in fasting normal man, does not respond readily to nutritional manipulation. Gluconeogenesis and mobilization of fat persist despite high levels of serum glucose. As a result, hypertonic glucose dosages are usually ineffective in stressed patients, and can actually lead to respiratory and hepatic complications. Recent studies have shown that fat emulsions given with carbohydrate can serve as a safe and efficacious alternative to glucose alone. Data continue to accumulate showing that nutritional support pre- and postoperatively is efficacious. The provision of daily calorie and protein requirements has a sound physiologic justification; routine use of 5% dextrose for prolonged periods (greater than 2 to 4 days) may result in prolonged convalescence.

Original languageEnglish (US)
Pages (from-to)12-18
Number of pages7
JournalNutrition International
Volume3
Issue number1
StatePublished - Jan 1 1987
Externally publishedYes

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Nutritional Support
Glucose
Hospitalization
Parenteral Nutrition
Morbidity
Serum Albumin
Mortality
Fats
Gluconeogenesis
Body Composition
Emulsions
Nutritional Status
Malnutrition
Wound Healing
Fasting
Retrospective Studies
Carbohydrates
Research Personnel
Liver
Serum

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Askanazi, J., Weissman, C., Rothkopf, M., & Starker, P. M. (1987). Perioperative nutritional support. Nutrition International, 3(1), 12-18.
Askanazi, J. ; Weissman, C. ; Rothkopf, Michael ; Starker, P. M. / Perioperative nutritional support. In: Nutrition International. 1987 ; Vol. 3, No. 1. pp. 12-18.
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Askanazi, J, Weissman, C, Rothkopf, M & Starker, PM 1987, 'Perioperative nutritional support', Nutrition International, vol. 3, no. 1, pp. 12-18.

Perioperative nutritional support. / Askanazi, J.; Weissman, C.; Rothkopf, Michael; Starker, P. M.

In: Nutrition International, Vol. 3, No. 1, 01.01.1987, p. 12-18.

Research output: Contribution to journalArticle

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Askanazi J, Weissman C, Rothkopf M, Starker PM. Perioperative nutritional support. Nutrition International. 1987 Jan 1;3(1):12-18.