Revising concepts of artificial nutrition in contemporary surgery: from energy and nitrogen to immuno-metabolic support.

Abstract:

:Profound changes in perioperative management, namely "fast track surgery" have been recently proposed. This is a bundle of various techniques used for subjects undergoing elective operations that allows an improved well-being, faster recovery, shorter hospitalization and better outcome. From a nutritional point of view this new approach translates into a more rapid return of bowel function and thus to safely tolerate oral re-feeding within 1-3 days even after major operations. Nevertheless, the classic indications for perioperative artificial nutritional support remain valid but they should now apply only to a minority of patients. Extensive research in the last 20 years has clearly shown that modifying the composition of standard nutritional feeds by adding supernormal doses of specific substrates that have immuno-modulatory, anti-inflammatory, anabolic, and tissue protective ability often translates into improved surgical outcome. The most convincing and reproducible results were obtained on the reduction of infectious complication by the perioperative use of enteral formulas enriched with arginine and omega-3 fatty acids.

journal_name

Nutr Hosp

journal_title

Nutricion hospitalaria

authors

Gianotti L,Braga M

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

56-67

issue

1

eissn

0212-1611

issn

1699-5198

pii

S0212-16112011000100006

journal_volume

26

pub_type

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