Terapia nutricional y pre-habilitación multimodal en el paciente quirúrgico no crítico. Una revisión.
DOI:
https://doi.org/10.31837/cir.urug/2.2.5Palabras clave:
Terapia nutricional, cirugía, riesgo nutricional, inmunonutrición, ayuno preoperatorio, prehabilitación en cirugíaResumen
Los pacientes quirúrgicos a menudo tienen un alto riesgo nutricional y esto se asocia con resultados posoperatorios deficientes, poniendo la supervivencia en riesgo.La identificación precoz de este tipo de pacientes es esencial para las intervenciones nutricionales tempranas con el objetivo de atenuar el catabolismo y preservar los procesos de respuesta al estrés quirúrgico que promueven la recuperación e inmunoprotección, reducen la morbimortalidad perioperatoria y mejoran los resultados quirúrgicos.En los últimos años, se han estudiado diversas estrategias nutricionales durante el período perioperatorio que han mostrado beneficios.El objetivo de la presente revisión es analizar la evidencia más reciente sobre la terapia nutricional en pacientes quirúrgicos no críticos; para ello se han consultado bases de datos electrónicas como PubMed, y revistas de las principales sociedades científicas competentes en la materia.
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Waitzberg DL, Caiaffa WT, Correia MI. Hospital malnutrition: The Brazilian national survey (IBRANUTRI): a study of 4000 patients. Nutrition 2001; 17(7-8): 573-80.
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Carli F, Zavorsky GS. Optimizing functional exercise capacity in the elderly surgical population. Curr Opin Clin Nutr Metab Care. 2005;8(1):23–32.
Strickland A, Brogan A, Krauss J, Martindale R, Cresci G. Is the use of specialized nutritional formulations a cost-effective strategy? A national database evaluation. Journal J Parenter Enteral Nutr 2005; 29(Suppl. 1): S81– 91. Doi 10.1177/01486071050290S1S81
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Weimann A, Braga M, Carli F, Higashiguchi T, Hübner M, Klek S, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr, 2017; 36):623-50.
Kondrup J, Allison SP, Elia M, Vellas B, Plauth M, Educational and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN). ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003;22: 415e21.
Hennessey DB, Burke JP, Ni-Dhonochu T, Shields C, Winter DC, Mealy K. Preoperative hypoalbuminemia is an independent risk factor for the development of surgical site infection following gastrointestinal surgery: a multi-institutional study. Ann. Surg. 2010;252:325–9.
Kudsk KA, Tolley EA, DeWitt RC, Janu PG, Blackwell AP, Yeary S, King BK. Preoperative albumin and surgical site identify surgical risk for major postoperative complications. J Parenter Enteral Nutr 2003;27:1–9.
Mueller C, Compher C, Ellen DM. A.S.P.E.N. clinical guidelines: nutrition screening, assessment, and intervention in adults. J Parenter Enteral Nutr 2011; 35: 16–24.
Kondrup J, Rasmussen HH, Hamberg O, Stanga Z. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 2003; 22: 321–36.
Gupta D, Vashi PG, Lammersfeld CA, Braun DP. Role of nutritional status in predicting the length of stay in cancer: a systematic review of the epidemiological literature. Ann Nutr Metab 2011;59:96-106.
Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S, et al. Diagnostic criteria for malnutrition - an ESPEN consensus statement. Clin Nutr 2015; 34:335-40.
Evans DC, Martindale RG, Kiraly LN, Jones CM. Nutrition optimization prior to surgery. Nutr Clin Pract 2014; 29:10–21.
Toh SY, Zarshenas N, Jorgensen J. Prevalence of nutrient deficiencies in bariatric patients. Nutrition 2009; 25:1150– 6.
Valentijn TM, Galal W, Tjeertes EK, Hoeks SE, Verhagen HJ, Stolker RJ. The obesity paradox in the surgical population. Surgeon 2013; 11:169–76.
Maltby JR. Fasting from midnight – the history behind the dogma. Best Pract Res ClinAnaesthesiol 2006; 20: 363–78.
Awad S, Lobo DN. What’s new in perioperative nutritional support? Curr Opin Anaesthesiol 2011;24:339–48
Wind J1, Polle SW, Fung Kon Jin PH, Dejong CH, von Meyenfeldt MF, Ubbink DT et al. Systematic review of enhanced recovery programmes in colonic surgery. Br J Surg. 2006;93(7):800-9.
Soreide E, Eriksson LI, Hirlekar G, et al. Pre-operative fasting guidelines: an update. Acta Anaesthesiol Scand 2005; 49:1041–7.
Brady M, Kinn S, Stuart P. Preoperative fasting for adults to prevent perioperative complications. The Cochrane Database of Systematic Reviews 2003; 4: CD004423.
American Society of Anesthesiologists. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters. Anesthesiol 2011;114:495–511.
Lambert E, Carey S. C. Practice Guideline Recommendations on Perioperative Fasting: a systematic review. J Parenter Enteral Nutr 2015. doi 10.1177/0148607114567713.
Nygren J, Thorell A, Ljungqvist O. Are there any benefits from minimizing fasting and optimization of nutrition and fluid management for patients undergoing day surgery? Curr Op Anaesthesiol. 2007;20: 540–4.
Nygren J, Soop M, Thorell A, Efendic S, Nair KS, Ljungqvist O. Preoperative oral carbohydrate administration reduces postoperative insulin resistance. Clin Nutr. 1998;17:65–71.
Ljungqvist O, Thorell A, Gutniak M, Haggmark T, Efendic S. Glucose infusion instead of preoperative fasting reduces postoperative insulin resistance. J Am Coll Surg 1994;178:329–36.
Bilku DK, Dennison AR, Hall TC, Metcalfe MS, Garcea G. Role of preoperative carbohydrate loading: a systematic review. Ann R Coll Surg Engl 2014;96:15–22.
Awad S, Varadhan KK, Ljungqvist O, Lobo DN. A meta-analysis of randomised controlled trials on preoperative oral carbohydrate treatment in elective surgery. Clin Nutr 2013;32:34–44.
Gustafsson UO, Scott MJ, Schwenk W, et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg 2013;37: 259–84.
Weimann A, Braga M, Carli F, Higashiguchi T, Hübner M, Klek S, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr 2017;36:623-50.
Huhmann MB, August DA. Nutrition support in surgical oncology. Nutr Clin Pract 2009; 24: 520–6.
Burden S, Todd C, Hill J, Lal S. Pre-operative nutrition support in patients undergoing gastrointestinal surgery. The Cochrane Database of Systematic Reviews 2012; 11: CD008879
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2019-07-15
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Moreira E, López P, Silva L, Olano E. Terapia nutricional y pre-habilitación multimodal en el paciente quirúrgico no crítico. Una revisión. Cir. Urug. [Internet]. 15 de julio de 2019 [citado 19 de abril de 2024];2(2):35-5. Disponible en: https://revista.scu.org.uy/index.php/cir_urug/article/view/45
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