Perioperative nutrition 360: an evidence-based model of care

Perioperative nutrition

Authors

DOI:

https://doi.org/10.12873/423pinzon

Keywords:

Arginine; Fatty Acids. Nucleotides; General Surgery; Nutritional Support; Cost Analysis.

Abstract

The present literature review allows us to propose a model of action for the timely identification of patients who require major surgery and who may benefit from nutritional interventions such as immunonutrition based on scientific evidence. Methodologically, it included a rapid review of the literature by consulting the following data sources: EMBASE, MEDLINE (Pubmed), Cochrane Database of Systematic Reviews (Wiley), LILACS (BVS, iAHx interface) and the Google Scholar search engine. As a result, 40 articles were identified, which met the parameters established for the systematic review and the quality criteria, which allowed establishing four phases for the proposal of nutritional intervention 360 in perioperative nutritional management, routine nutritional screening in outpatient clinic, preoperative supplementation with therapeutic doses of immunonutrition, in-hospital nutritional intervention and postoperative nutritional follow-up. In conclusion, a nutritional intervention model that includes a nutritional contribution with a formula of amino acids (arginine and/or glutamine), polyunsaturated fatty acids (omega-3 fatty acid) and a mixture of nucleotides or RNA, is a cost-effective strategy in elective surgery patients for gastrointestinal cancer (stomach and colon cancer), head and neck surgery, patients over 18 years of age.

Author Biographies

  • María del Pilar Morales Huertas, https://orcid.org/0000-0002-9393-3867

    Nutricionista - Diestista

    Epidemiologa (candidata)

  • Juan Guillermo Ariza Lozano

    Médico 

    Medical Affairs Leader - Improve clinical practice, advance in medical science and promote better patient and healthcare system outcomes.
  • Josef Kling Gómez

    Médico

    Especialista en Cirugía 

References

Drover JW.; Dhaliwal R, Weitzel L, Wischmeyer PE, Ochoa JB, Heyland DK. Perioperative use of arginine-supplemented diets: a systematic review of the evidence. J Am Coll Surg. 2011;212(3):385-399.e1. DOI: https://doi.org/10.1016/j.jamcollsurg.2010.10.016

Martindale RG.; McClave SA, Taylor B, Lawson CM. Perioperative nutrition: what is the current landscape?. JPEN J Parenter Enteral Nutr. 2013;37(5 Suppl):5S-20S. DOI: https://doi.org/10.1177/0148607113496821

Arends J.; Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11-48. DOI: https://doi.org/10.1016/j.clnu.2016.07.015

Schwegler I.; von Holzen A, Gutzwiller JP, Schlumpf R, Mühlebach S, Stanga Z. Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer. Br J Surg. 2010;97(1):92-97. DOI: https://doi.org/10.1002/bjs.6805

Yu K; Zheng X, Wang G, et al. Immunonutrition vs Standard Nutrition for Cancer Patients: A Systematic Review and Meta-Analysis (Part 1). JPEN J Parenter Enteral Nutr. 2020;44(5):742-767. DOI: https://doi.org/10.1002/jpen.1736

Cerantola Y.; Hübner M, Grass F, Demartines N, Schäfer M. Immunonutrition in gastrointestinal surgery. Br J Surg. 2011;98(1):37-48. DOI: https://doi.org/10.1002/bjs.7273

Probst P.; Ohmann S, Klaiber U, et al. Meta-analysis of immunonutrition in major abdominal surgery. Br J Surg. 2017;104(12):1594-1608. DOI: https://doi.org/10.1002/bjs.10659

Soares AD.; Costa KA, Wanner SP, et al. Dietary glutamine prevents the loss of intestinal barrier function and attenuates the increase in core body temperature induced by acute heat exposure. Br J Nutr. 2014;112(10):1601-1610. DOI: https://doi.org/10.1017/S0007114514002608

Efron D.; Barbul A. Role of arginine in immunonutrition. J Gastroenterol. 2000;35 Suppl 12:20-23.

Martin JM.; Stapleton RD. Omega-3 fatty acids in critical illness. Nutr Rev. 2010;68(9):531-541. DOI: https://doi.org/10.1111/j.1753-4887.2010.00313.x

Marik PE.; Zaloga GP. Immunonutrition in high-risk surgical patients: a systematic review and analysis of the literature. JPEN J Parenter Enteral Nutr. 2010;34(4):378-386. DOI: https://doi.org/10.1177/0148607110362692

Mauskopf JA.; Candrilli SD, Chevrou-Séverac H, Ochoa JB. Immunonutrition for patients undergoing elective surgery for gastrointestinal cancer: impact on hospital costs. World J Surg Oncol. 2012;10:136. DOI: https://doi.org/10.1186/1477-7819-10-136

Waitzberg DL.; Saito H, Plank LD, et al. Postsurgical infections are reduced with specialized nutrition support. World J Surg. 2006;30(8):1592-1604. DOI: https://doi.org/10.1007/s00268-005-0657-x

Dobbins, M. "Rapid review guidebook." Natl. Collab. Cent. Method Tools 13 (2017): 25.

Meijers JM.; Tan F, Schols JM, Halfens RJ. Nutritional care; do process and structure indicators influence malnutrition prevalence over time?. Clin Nutr. 2014;33(3):459-465. DOI: https://doi.org/10.1016/j.clnu.2013.06.015

Geiker NR.; Horup Larsen SM, Stender S, Astrup A. Poor performance of mandatory nutritional screening of in-hospital patients. Clin Nutr. 2012;31(6):862-867. DOI: https://doi.org/10.1016/j.clnu.2012.03.006

de Las Peñas R.; Majem M, Perez-Altozano J, et al. SEOM clinical guidelines on nutrition in cancer patients (2018). Clin Transl Oncol. 2019;21(1):87-93. DOI: https://doi.org/10.1007/s12094-018-02009-3

Thompson KL.; Elliott L, Fuchs-Tarlovsky V, Levin RM, Voss AC, Piemonte T. Oncology Evidence-Based Nutrition Practice Guideline for Adults. J Acad Nutr Diet. 2017;117(2):297-310.e47. DOI: https://doi.org/10.1016/j.jand.2016.05.010

Braga M. Perioperative immunonutrition and gut function. Curr Opin Clin Nutr Metab Care. 2012;15(5):485-488. DOI: https://doi.org/10.1097/MCO.0b013e3283567d8f

Cheng Y.; Zhang J, Zhang L, Wu J, Zhan Z. Enteral immunonutrition versus enteral nutrition for gastric cancer patients undergoing a total gastrectomy: a systematic review and meta-analysis. BMC Gastroenterol. 2018;18(1):11. Published 2018 Jan 16. DOI: https://doi.org/10.1186/s12876-018-0741-y

Ida S.; Hiki N, Cho H, et al. Randomized clinical trial comparing standard diet with perioperative oral immunonutrition in total gastrectomy for gastric cancer. Br J Surg. 2017;104(4):377-383. DOI: https://doi.org/10.1002/bjs.10417

Song GM.; Liu XL, Bian W, et al. Systematic review with network meta-analysis: comparative efficacy of different enteral immunonutrition formulas in patients underwent gastrectomy. Oncotarget. 2017;8(14):23376-23388. DOI: https://doi.org/10.18632/oncotarget.15580

Braga M.; Wischmeyer PE, Drover J, Heyland DK. Clinical evidence for pharmaconutrition in major elective surgery. JPEN J Parenter Enteral Nutr. 2013;37(5 Suppl):66S-72S. DOI: https://doi.org/10.1177/0148607113494406

Weimann A.; Braga M, Harsanyi L, et al. ESPEN Guidelines on Enteral Nutrition: Surgery including organ transplantation. Clin Nutr. 2006;25(2):224-244. DOI: https://doi.org/10.1016/j.clnu.2006.01.015

McClave SA.; Kozar R, Martindale RG, et al. Summary points and consensus recommendations from the North American Surgical Nutrition Summit. JPEN J Parenter Enteral Nutr. 2013;37(5 Suppl):99S-105S. DOI: https://doi.org/10.1177/0148607113495892

Ali Abdelhamid Y.; Chapman MJ, Deane AM. Peri-operative nutrition. Anaesthesia. 2016;71 Suppl 1:9-18. DOI: https://doi.org/10.1111/anae.13310

Banerjee S.; Garrison LP, Danel A, Ochoa Gautier JB, Flum DR. Effects of arginine-based immunonutrition on inpatient total costs and hospitalization outcomes for patients undergoing colorectal surgery. Nutrition. 2017;42:106-113. DOI: https://doi.org/10.1016/j.nut.2017.06.002

Ukleja A.; Gilbert K, Mogensen KM, et al. Standards for Nutrition Support: Adult Hospitalized Patients. Nutr Clin Pract. 2018;33(6):906-920. DOI: https://doi.org/10.1002/ncp.10204

Burden S.; Todd C, Hill J, Lal S. Pre-operative nutrition support in patients undergoing gastrointestinal surgery. Cochrane Database Syst Rev. 2012;11:CD008879. DOI: https://doi.org/10.1002/14651858.CD008879.pub2

Lewis SJ.; Andersen HK, Thomas S. Early enteral nutrition within 24 h of intestinal surgery versus later commencement of feeding: a systematic review and meta-analysis. J Gastrointest Surg. 2009;13(3):569-575. DOI: https://doi.org/10.1007/s11605-008-0592-x

Steed HL.; Capstick V, Flood C, Schepansky A, Schulz J, Mayes DC. A randomized controlled trial of early versus "traditional" postoperative oral intake after major abdominal gynecologic surgery. Am J Obstet Gynecol. 2002;186(5):861-865. DOI: https://doi.org/10.1067/mob.2002.123057

Lewis SJ.; Egger M, Sylvester PA, Thomas S. Early enteral feeding versus "nil by mouth" after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ. 2001;323(7316):773-776. DOI: https://doi.org/10.1136/bmj.323.7316.773

Braga M.; Ljungqvist O, Soeters P, et al. ESPEN Guidelines on Parenteral Nutrition: surgery. Clin Nutr. 2009;28(4):378-386. DOI: https://doi.org/10.1016/j.clnu.2009.04.002

McClave SA.; Martindale R, Taylor B, Gramlich L. Appropriate use of parenteral nutrition through the perioperative period. JPEN J Parenter Enteral Nutr. 2013;37(5 Suppl):73S-82S. DOI: https://doi.org/10.1177/0148607113495570

Yanok RMP.; SA IIM, Chau SH, SENG KJSM. A Systematic Review on the Effectiveness of Enteral Immunonutrition (EIN) on Pre-and Post-Operative Outcomes in Gastric Cancer Patients. 2020;49(3):625-34. DOI: https://doi.org/10.17576/jsm-2020-4903-17

Xu J.; Sun X, Xin Q, et al. Effect of immunonutrition on colorectal cancer patients undergoing surgery: a meta-analysis. Int J Colorectal Dis. 2018;33(3):273-283. DOI: https://doi.org/10.1007/s00384-017-2958-6

Braga M.; Gianotti L. Preoperative immunonutrition: cost-benefit analysis. JPEN J Parenter Enteral Nutr. 2005;29(1 Suppl):S57-S61. DOI: https://doi.org/10.1177/01486071050290S1S57

Barreiro E.; Sánchez R, Diz S, Piñeiro A, Seoane J, Carrera E. Impacto de la terapia con inmunonutrición oral perioperatoria en pacientes sometidos a cirugía por cáncer colorrectal [Impact of preoperative oral nutrition therapy in patients undergoing surgery for colorectal cancer]. Nutr Hosp. 2019;36(5):1150-1156.

Weimann A.; Braga M, Carli F, et al. ESPEN practical guideline: Clinical nutrition in surgery. Clin Nutr. 2021;40(7):4745-4761. DOI: https://doi.org/10.1016/j.clnu.2021.03.031

Fujitani K.; Tsujinaka T, Fujita J, et al. Prospective randomized trial of preoperative enteral immunonutrition followed by elective total gastrectomy for gastric cancer. Br J Surg. 2012;99(5):621-629. DOI: https://doi.org/10.1002/bjs.8706

Marano L.; Porfidia R, Pezzella M, et al. Clinical and immunological impact of early postoperative enteral immunonutrition after total gastrectomy in gastric cancer patients: a prospective randomized study. Ann Surg Oncol. 2013;20(12):3912-3918. DOI: https://doi.org/10.1245/s10434-013-3088-1

Reeves C.; Deeks J, and Higgins J.P. "13 Including non-randomized studies." Cochrane handbook for systematic reviews of interventions 1 (2008): 391. DOI: https://doi.org/10.1002/9780470712184.ch13

Williams D.; Molinger J, Wischmeyer P. The malnourished surgery patient: a silent epidemic in perioperative outcomes?. Curr Opin Anaesthesiol. 2019;32(3):405-411. DOI: https://doi.org/10.1097/ACO.0000000000000722

Downloads

Published

2022-08-25

Issue

Section

Reviews

Categories

How to Cite

[1]
2022. Perioperative nutrition 360: an evidence-based model of care: Perioperative nutrition . Nutrición Clínica y Dietética Hospitalaria. 42, 3 (Aug. 2022). DOI:https://doi.org/10.12873/423pinzon.

Similar Articles

1-10 of 608

You may also start an advanced similarity search for this article.