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Optimizing Nutritional Status of Patients Prior to Major Surgical Intervention Cover

Optimizing Nutritional Status of Patients Prior to Major Surgical Intervention

Methodist DeBakey Cardiovascular Journal
Volume 19 (2023): Issue 4
By: ,   and    
Open Access
|Aug 2023
Figures & tables

Figures & Tables

Figure 1

Clinical practice guidelines for frailty followed by the Houston Methodist Hospital outpatient transplant team.

Table 1

The Enhanced Recovery After Surgery nutrition-related recommendations for general surgery and subspecialized populations including cardiac, lung, and esophagectomy patients.

Preadmission

  • Preoperative nutritional screening and assessment plus nutritional support

  • Esophagectomy: in high-risk cases, preference to enteral support by feeding tubes

  • Optimization of chronic disease (identification of hyperglycemia and optimization of diabetes mellitus)

Preoperative

  • Preoperative carbohydrate loading

  • Cardiac surgery: minimize fasting by continuing clear liquids up to 2 to 4 hours before anesthesia

Intraoperative

  • Maintenance of fluid balance avoiding both under- and over-hydration

  • Esophagectomy: avoid positive balance resulting in weight gain > 2 kg/d

Postoperative

  • Early intake of fluids and solids

  • Intake of nutritional supplements

  • Cardiac surgery: insulin infusion in all patients with postoperative hyperglycemia

  • Esophagectomy: enteral feeding with nutritional rate on target by day 3-6

DOI: https://doi.org/10.14797/mdcvj.1248 | Journal eISSN: 1947-6108
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Language: English
Page range: 85 - 96
Submitted on: Apr 24, 2023
Accepted on: Jun 16, 2023
Published on: Aug 1, 2023
Published by: Houston Methodist DeBakey Heart & Vascular Center
In partnership with: Paradigm Publishing Services
Keywords:
ERAS®,
Enhanced Recovery After Surgery,
surgical nutrition guidelines,
malnutrition,
malnutrition screening,
frailty,
sarcopenia,
perioperative,
PONS,
perioperative nutrition screen

© 2023 Raul M. Sanchez Leon, Anjana Rajaraman, Mitzi N. Kubwimana, published by Houston Methodist DeBakey Heart & Vascular Center
This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 License.

Volume 19 (2023): Issue 4
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