Basics in Clinical Nutrition: Perioperative Nutrition

e-SPEN, European e-Journal of Clinical Nutrition and Metabolism. 2010 Apr 1; 5(2):E93-E96. doi: 10.1016/j.eclnm.2009.06.011. Epub 2009 Aug 25.
Ljungqvist, O., Dardai, E., & Allison, S. P.


Learning objectives

  • To understand how to feed the surgical patient and understand the indications for preoperative and postoperative enteral or parenteral nutrition

Surgery involves a deliberate injury to the body inflicted for the overall benefit of the patient. The surgical insult results in several responses that cause a change in metabolism towards catabolism. Recovery from surgery requires a reversal of the trauma-induced catabolism towards anabolism. There are many ways by which the catabolic responses can be minimized and anabolism supported. Nutrition, the supply of energy and protein, represents an essential part of the perioperative treatment.

It is important to understand that for the majority of patients undergoing surgery, the nutritional treatment stimulates faster recovery. Most of these patients can eat and should be given oral food. The target of nutritional treatment should be to optimise fluid intake and ensure sufficient energy and protein intake orally.

A much smaller group of surgical patients are malnourished. These patients have a higher risk of mortality, complications, prolonged hospital stay and delayed rehabilitation and convalescence. Although some early studies of perioperative nutritional support were conflicting, over the last twenty years a succession of studies have begun to define those groups of patients who benefit, particularly those with prior malnutrition.

Because of the risks associated with malnutrition and surgery, all patients about to undergo surgery should be screened and assessed for nutritional status. Those with malnutrition should be considered for perioperative nutritional support. It is useful to consider the problem in three phases pre-, per- and postoperative.

Information NutriBib

Reference work for leading, current and selected literature in the field of clinical nutrition

Publications on clinical nutrition have grown steadily in recent years and the scientific evidence has been improved by numerous observational as well as intervention studies. Various umbrella organisations, such as the Swiss Society for Clinical Nutrition (GESKES), the German Society for Nutritional Medicine (DGEM) or the European Society for Clinical Nutrition and Metabolism (ESPEN) publish guidelines on nutrition in various clinical situations at regular intervals. Thus, a large amount of literature is available for evidence-based nutritional medicine.

The NutriBib aims to filter out authoritative publications in the various fields of nutritional medicine and thus to provide an overview of the abundance of literature. A large number of experienced nutrition experts contributed to the selection of relevant sources and allow a broadly based selection. Nevertheless, the literature selection cannot be considered exhaustive. Specific literature can be found by entering search words (using the magnifying glass at the top right) or by searching the table of contents.

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List of abbreviations

DGEM German Society for Nutritional Medicine (German Deutsche Gesellschaft für Ernährungsmedizin)
GESKES  Swiss Society for Clinical Nutrition (German Gesellschaft für klinische Ernährung der Schweiz) 
ESPEN European Society of Clinicl Nutrition and Metabolism