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perioperative nutritional support

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https://www.readbyqxmd.com/read/28429903/causes-of-interruptions-in-postoperative-enteral-nutrition-in-children-with-congenital-heart-disease
#1
Jirong Qi, Zhuo Li, Yueshuang Cun, Xiaonan Li
BACKGROUND AND OBJECTIVES: Perioperative nutritional support has become a hot topic in the clinical management of congenital heart disease (CHD). Postoperative enteral nutrition (EN) offers many benefits, such as protection of the intestinal mucosa, reduced risk of infection, and low clinical costs. Interruptions in EN frequently influence nutritional support and clinical outcomes. We, therefore, aimed to determine the causes of interruptions in postoperative EN in CHD patients and discuss clinical counter measures...
May 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28361743/the-role-of-nutritional-assessment-and-early-enteral-nutrition-for-combined-pancreas-and-kidney-transplant-candidates
#2
Sally Finlay, Argiris Asderakis, Adel Ilham, Doruk Elker, Dawn Chapman, Elijah Ablorsu
BACKGROUND: Early post-operative enteral nutrition is an important part of perioperative management and is strongly supported by ESPEN Guidelines. However, there is limited evidence into the use of Early Enteral Nutrition (EEN) after combined Pancreas and Kidney Transplantation (PKT). We know malnutrition in type-1 diabetics with end stage renal failure (ESRF) is a common problem and a significant risk factor. Therefore, we introduced EEN in our patients. METHOD: We monitored and recorded nutritional data on 29 PKT recipients who underwent transplantation between Oct 2007 and Jan 2010 without a nutritional assessment or EEN [Monitored Group (MG)] and on 30 PKT recipients between Feb 2010 and Dec 2013 who received a nutritional assessment and EEN (Naso-jejunal feed or oral intake with supplementation, according to their nutritional status) [Fed Group (FG)]...
February 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28338158/-diagnosis-and-treatment-of-duodenal-injury-and-fistula
#3
Kunmei Gong, Shikui Guo, Kunhua Wang
Duodenal injury is a serious abdominal organ injury. Duodenal fistula is one of the most serious complications in gastrointestinal surgery, which is concerned for its critical status, difficulty in treatment and high mortality. Thoracic and abdominal compound closed injury and a small part of open injury are common causes of duodenal injury. Iatrogenic or traumatic injury, malnutrition, cancer, tuberculosis, Crohn's disease etc. are common causes of duodenal fistula, however, there has been still lacking of ideal diagnosis and treatment by now...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28296670/intraoperative-feeding-improves-calorie-and-protein-delivery-in-acute-burn-patients
#4
David E Varon, Gil Freitas, Neha Goel, Jennifer Wall, Deepak Bharadia, Erin Sisk, Joshua C Vacanti, Bohdan Pomahac, Indranil Sinha, Vihas M Patel
Enteral nutrition support is a critical component of modern burn care for severely burned patients. However, tube feeds are frequently withheld during the perioperative period because of aspiration concerns. As a result, patients requiring multiple operative procedures risk accumulating significant protein-calorie deficits. The objective of this study was to describe our American Burn Association-certified burn center's experience implementing an intraoperative feeding protocol in severely burned patients defined as a cutaneous burn ≥20% TBSA...
March 6, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28272344/nutritional-and-metabolic-derangements-in-pancreatic-cancer-and-pancreatic-resection
#5
REVIEW
Taylor M Gilliland, Nicole Villafane-Ferriol, Kevin P Shah, Rohan M Shah, Hop S Tran Cao, Nader N Massarweh, Eric J Silberfein, Eugene A Choi, Cary Hsu, Amy L McElhany, Omar Barakat, William Fisher, George Van Buren
Pancreatic cancer is an aggressive malignancy with a poor prognosis. The disease and its treatment can cause significant nutritional impairments that often adversely impact patient quality of life (QOL). The pancreas has both exocrine and endocrine functions and, in the setting of cancer, both systems may be affected. Pancreatic exocrine insufficiency (PEI) manifests as weight loss and steatorrhea, while endocrine insufficiency may result in diabetes mellitus. Surgical resection, a central component of pancreatic cancer treatment, may induce or exacerbate these dysfunctions...
March 7, 2017: Nutrients
https://www.readbyqxmd.com/read/28131521/espen-guideline-clinical-nutrition-in-inflammatory-bowel-disease
#6
Alastair Forbes, Johanna Escher, Xavier Hébuterne, Stanisław Kłęk, Zeljko Krznaric, Stéphane Schneider, Raanan Shamir, Kalina Stardelova, Nicolette Wierdsma, Anthony E Wiskin, Stephan C Bischoff
INTRODUCTION: The ESPEN guideline presents a multidisciplinary focus on clinical nutrition in inflammatory bowel disease (IBD). METHODOLOGY: The guideline is based on extensive systematic review of the literature, but relies on expert opinion when objective data were lacking or inconclusive. The conclusions and 64 recommendations have been subject to full peer review and a Delphi process in which uniformly positive responses (agree or strongly agree) were required...
April 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28093897/presence-of-early-stage-cancer-does-not-impair-the-early-protein-metabolic-response-to-major-surgery
#7
Mariëlle P K J Engelen, V Suzanne Klimberg, Arianna Allasia, Nicolaas Ep Deutz
BACKGROUND: Combined bilateral mastectomy and reconstruction is a common major surgical procedure in women with breast cancer and in those with a family history of breast cancer. As this large surgical procedure induces muscle protein loss, a preserved anabolic response to nutrition is warranted for optimal recovery. It is unclear whether the presence of early stage cancer negatively affects the protein metabolic response to major surgery as this would mandate perioperative nutritional support...
January 16, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28072447/randomized-clinical-trial-comparing-standard-diet-with-perioperative-oral-immunonutrition-in-total-gastrectomy-for-gastric-cancer
#8
RANDOMIZED CONTROLLED TRIAL
S Ida, N Hiki, H Cho, K Sakamaki, S Ito, K Fujitani, N Takiguchi, Y Kawashima, K Nishikawa, M Sasako, T Aoyama, M Honda, T Sato, S Nunobe, T Yoshikawa
BACKGROUND: Total gastrectomy for gastric cancer is associated with excessive weight loss and decreased calorie intake. Nutritional support using eicosapentaenoic acid modulates immune function and limits catabolism in patients with advanced cancer, but its impact in the perioperative period is unclear. METHODS: This was a randomized phase III clinical trial of addition of eicosapentaenoic acid-rich nutrition to a standard diet in patients having total gastrectomy for gastric cancer...
March 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28061830/age-nutrition-chirugie-anc-study-impact-of-a-geriatric-intervention-on-the-screening-and-management-of-undernutrition-in-elderly-patients-operated-on-for-colon-cancer-a-stepped-wedge-controlled-trial
#9
Marine Dupuis, Elisabetta Kuczewski, Laurent Villeneuve, Sylvie Bin-Dorel, Max Haine, Claire Falandry, Thomas Gilbert, Guillaume Passot, Olivier Glehen, Marc Bonnefoy
BACKGROUND: Undernutrition prior to major abdominal surgery is frequent and increases morbidity and mortality, especially in older patients. The management of undernutrition reduces postoperative complications. Nutritional management should be a priority in patient care during the preoperative period. However undernutrition is rarely detected and the guidelines are infrequently followed. Preoperative undernutrition screening should allow a better implementation of the guidelines. METHODS/DESIGN: The ANC ("Age Nutrition Chirurgie") study is an interventional, comparative, prospective, multicenter, randomized protocol based on the stepped wedge trial design...
January 7, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28054107/-evidence-based-supportive-measures-to-secure-pancreatic-anastomoses
#10
O Belyaev, W Uhl
BACKGROUND: Pancreatic anastomosis is the Achilles heel of pancreatic surgery. Despite substantial progress in surgical techniques the rate of postoperative pancreatic fistulas remains very high. For this reason various supportive measures to secure pancreatic anastomoses are of continuing interest. OBJECTIVE: This review presents the newest evidence-based data on supportive measures designed to secure a pancreatic anastomosis. MATERIAL AND METHODS: The most recent meta-analyses, randomized controlled trials and the largest retrospective studies on the role of pancreatic duct stenting, double loop reconstruction, autologous patches and drainage in pancreaticoduodenectomy were taken into account...
January 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28032565/surgical-site-infection-after-stoma-closure-in-children-outcomes-and-predictors
#11
Dani O Gonzalez, Erica Ambeba, Peter C Minneci, Katherine J Deans, Benedict C Nwomeh
BACKGROUND: Surgical site infection (SSI) is a burdensome complication following intestinal stoma closure, with reported rates ranging from 0% to 40%. We aimed to identify risk factors for SSI in children undergoing stoma closure. MATERIALS AND METHODS: Using 2012-2014 NSQIP Pediatric data, we identified patients aged 0-18 years undergoing stoma closure. Demographic, clinical, and 30-day outcome characteristics between children with and without SSI were compared...
November 4, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27889271/assessment-of-perioperative-nutrition-practices-and-attitudes-a-national-survey-of-colorectal-and-gi-surgical-oncology-programs
#12
J D Williams, Paul E Wischmeyer
BACKGROUND: Implementation of evidence-based peri-operative nutrition in the U.S. is poorly described and hypothesized to be suboptimal. This study broadly describes practices and attitudes regarding nutrition screening/intervention in U.S. gastrointestinal and oncologic surgeons. METHODS: Nationwide nutritional practice survey of GI/Oncologic surgical faculty. RESULTS: Program response rates were 57% and 81% for colorectal and oncology fellowships, respectively...
November 17, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27780971/patient-optimization-for-surgery-relating-to-crohn-s-disease
#13
REVIEW
Kamal V Patel, Amir A Darakhshan, Nyree Griffin, Andrew B Williams, Jeremy D Sanderson, Peter M Irving
The majority of patients with Crohn's disease require abdominal surgery during their lifetime, some of whom will require multiple operations. Postoperative complications are seen more frequently in patients requiring abdominal surgery for Crohn's disease than in patients requiring abdominal surgery for other conditions. In this article, we review the evidence supporting preoperative optimization, discussing strategies that potentially improve surgical outcomes and reduce perioperative morbidity and mortality...
December 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27756322/effectiveness-of-postoperative-elemental-diet-elental%C3%A2-in-elderly-patients-after-gastrectomy
#14
Yu Ohkura, Shusuke Haruta, Tsuyoshi Tanaka, Masaki Ueno, Harushi Udagawa
BACKGROUND: We aimed to investigate the efficacy of postoperative early intervention with an elemental diet to reduce weight loss and enhance recovery after gastrectomy. Nutritional status and gastrointestinal immune function tend to worsen, and postoperative weight loss is inevitable in these patients; therefore, improvement in their postoperative condition is important, especially in gastric cancer patients aged ≥80 years. METHODS: Clinical outcomes and postoperative nutritional status were compared between 21 and 22 consecutive elderly patients aged ≥80 years who underwent distal gastrectomy before and after the introduction of postoperative oral elemental diet (Elental®, 300 kcal/day), respectively, between October 2011 and June 2016...
October 19, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27750261/does-nutrition-support-have-a-role-in-managing-cancer-cachexia
#15
Alessandro Laviano, Gianluca Di Lazzaro Giraldi, Angela Koverech
PURPOSE OF REVIEW: Cachexia is a negative prognostic factor in cancer patients. The pathogenesis is related to a variable combination of reduced food intake and metabolic changes. However, whether nutritional support may contribute to effectively prevent and treat cachexia remains a debated issue. RECENT FINDINGS: Consistent evidence demonstrates that anabolic windows of opportunity occur during the clinical trajectory of cancer patients. Also, the use of specific nutrients, namely omega-3 fatty acids, may enhance the efficacy of nutritional support when tumor-driven inflammatory response is high...
December 2016: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/27739314/the-impact-of-high-protein-nutritional-support-on-clinical-outcomes-and-treatment-costs-of-patients-with-colorectal-cancer
#16
V Maňásek, K Bezděk, A Foltys, K Klos, J Smitka, D Smehlik
BACKGROUND: The primary objective of this study was to investigate the impact of high protein oral nutrition support (ONS) on clinical outcomes in patients with colorectal cancer (CRC). The secondary aim was to compare the cost of treatment and length of stay (LoS) for CRC patients taking high protein ONS vs. patients on conventional nutritional support. MATERIALS AND METHODS: The study was conducted on adult patients with CRC undergoing colorectal surgery. Informed consent was obtained before the study...
2016: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/27727026/best-practice-for-perioperative-management-of-patients-with-cytoreductive-surgery-and-hipec
#17
REVIEW
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27621004/impact-of-malnutrition-on-gastrointestinal-surgical-patients
#18
Catalina Mosquera, Nicholas J Koutlas, Kimberly C Edwards, Ashley Strickland, Nasreen A Vohra, Emmanuel E Zervos, Timothy L Fitzgerald
BACKGROUND: The accurate diagnosis of malnutrition is imperative if we are to impact outcomes in the malnourished. The American Society of Parenteral and Enteral Nutrition (ASPEN) and Academy of Nutrition and Dietetics (AND), in an attempt to address this issue, have provided evidence-based criteria to diagnose malnutrition. The purpose of this study was to validate the ASPEN/AND criteria in a cohort of patients from a single high-volume surgical oncology unit. METHODS: Patients undergoing major abdominal surgery from June 2013 to March 2015 were classified by their nutritional status using the ASPEN/AND criteria...
September 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27556777/nutrition-and-chronic-wounds-improving-clinical-outcomes
#19
Joseph A Molnar, Lucian G Vlad, Tuna Gumus
There is increasing awareness that chronic wound healing is very dependent on the patient's nutritional status, but there are no clearly established and accepted assessment protocols or interventions in clinical practice. Much of the data used as guidelines for chronic wound patients are extrapolated from acutely wounded trauma patients, but the 2 groups are very different patient populations. While most trauma patients are young, healthy, and well-nourished before injury, the chronic wound patient is usually old, with comorbidities and frequently malnourished...
September 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27490606/nutrition-and-mesenteric-issues-in-pediatric-cardiac-critical-care
#20
Alejandro A Floh, Julie Slicker, Steven M Schwartz
OBJECTIVES: The objectives of this review are to discuss the challenges of delivering adequate nutrition to children with congenital heart disease, including pre- and postoperative factors and the role of enteral and parenteral nutrition, as well as the evidence supporting current practices. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: Providing adequate nutritional support is paramount for critically ill infants with congenital heart disease, a population at particular risk for malnutrition...
August 2016: Pediatric Critical Care Medicine
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