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Postoperative parenteral nutrition

Author
Nicole Siparsky, MD, FACS
Section Editor
Hilary Sanfey, MD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS

INTRODUCTION

Malnutrition is associated with postoperative complications and an increased risk for death after surgery [1]. Many surgical diseases result in malnutrition, particularly those that are associated with a hypermetabolic state (eg, malignancy [2], inflammation [3], gastrointestinal dysfunction [4,5], and burns). Advanced age is also associated with malnutrition in hospitalized patients, many of whom require emergency operations [6]. Although nutritional optimization prior to surgery is an option for a select group of patients, in most cases, this is not possible [7].

An enteral route for nutrition is usually recommended if available because it stimulates the intestinal brush border, thereby preventing disuse atrophy and bacterial translocation. It also stimulates gallbladder emptying, thereby preventing bacterial stasis and cholecystitis. Enteral access is also less expensive and has fewer side effects and complications compared with central venous access, which is required for parenteral nutrition. Nevertheless, parenteral nutrition may be necessary for those patients with contraindications to enteral nutrition and for postoperative patients who are unable to meet their nutritional goals using the enteral route.

The indications and implementation of parenteral nutrition in postoperative patients are reviewed here. The consequences of malnutrition, nutritional assessment, indications for preoperative nutritional support, and implementation of enteral nutrition in surgical patients are reviewed elsewhere. (See "Overview of perioperative nutritional support".)

Nutritional support in specific patient populations is also discussed in more detail in separate topic reviews:

(See "Nutrition support in critically ill patients: An overview".)

                          

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Literature review current through: Nov 2016. | This topic last updated: Thu Sep 29 00:00:00 GMT+00:00 2016.
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