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Surgery and transplantation - Guidelines on Parenteral Nutrition, Chapter 18
In surgery, indications for artificial nutrition comprise prevention and treatment of catabolism and malnutrition. Thus in general, food intake should not be interrupted postoperatively and the re-establishing of oral (e.g. after anastomosis of the colon and rectum, kidney transplantation) or entera...
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Published in: | German medical science 2009-11, Vol.7, p.Doc10-Doc10 |
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description | In surgery, indications for artificial nutrition comprise prevention and treatment of catabolism and malnutrition. Thus in general, food intake should not be interrupted postoperatively and the re-establishing of oral (e.g. after anastomosis of the colon and rectum, kidney transplantation) or enteral food intake (e.g. after an anastomosis in the upper gastrointestinal tract, liver transplantation) is recommended within 24 h post surgery. To avoid increased mortality an indication for an immediate postoperatively artificial nutrition (enteral or parenteral nutrition (PN)) also exists in patients with no signs of malnutrition, but who will not receive oral food intake for more than 7 days perioperatively or whose oral food intake does not meet their needs (e.g. less than 60-80%) for more than 14 days. In cases of absolute contraindication for enteral nutrition, there is an indication for total PN (TPN) such as in chronic intestinal obstruction with a relevant passage obstruction e.g. a peritoneal carcinoma. If energy and nutrient requirements cannot be met by oral and enteral intake alone, a combination of enteral and parenteral nutrition is indicated. Delaying surgery for a systematic nutrition therapy (enteral and parenteral) is only indicated if severe malnutrition is present. Preoperative nutrition therapy should preferably be conducted prior to hospital admission to lower the risk of nosocomial infections. The recommendations of early postoperative re-establishing oral feeding, generally apply also to paediatric patients. Standardised operative procedures should be established in order to guarantee an effective nutrition therapy. |
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Thus in general, food intake should not be interrupted postoperatively and the re-establishing of oral (e.g. after anastomosis of the colon and rectum, kidney transplantation) or enteral food intake (e.g. after an anastomosis in the upper gastrointestinal tract, liver transplantation) is recommended within 24 h post surgery. To avoid increased mortality an indication for an immediate postoperatively artificial nutrition (enteral or parenteral nutrition (PN)) also exists in patients with no signs of malnutrition, but who will not receive oral food intake for more than 7 days perioperatively or whose oral food intake does not meet their needs (e.g. less than 60-80%) for more than 14 days. In cases of absolute contraindication for enteral nutrition, there is an indication for total PN (TPN) such as in chronic intestinal obstruction with a relevant passage obstruction e.g. a peritoneal carcinoma. If energy and nutrient requirements cannot be met by oral and enteral intake alone, a combination of enteral and parenteral nutrition is indicated. Delaying surgery for a systematic nutrition therapy (enteral and parenteral) is only indicated if severe malnutrition is present. Preoperative nutrition therapy should preferably be conducted prior to hospital admission to lower the risk of nosocomial infections. The recommendations of early postoperative re-establishing oral feeding, generally apply also to paediatric patients. Standardised operative procedures should be established in order to guarantee an effective nutrition therapy.</description><identifier>ISSN: 1612-3174</identifier><identifier>EISSN: 1612-3174</identifier><identifier>DOI: 10.3205/000069</identifier><identifier>PMID: 20049072</identifier><language>eng</language><publisher>Germany: German Medical Science GMS Publishing House</publisher><subject>fast track surgery ; Germany ; Humans ; Nutrition Disorders - etiology ; Nutrition Disorders - prevention & control ; Parenteral Nutrition - methods ; Parenteral Nutrition - standards ; Postoperative Complications - etiology ; Postoperative Complications - therapy ; postoperative nutrition ; Practice Guidelines as Topic ; surgery ; transplantation ; Transplantation - adverse effects</subject><ispartof>German medical science, 2009-11, Vol.7, p.Doc10-Doc10</ispartof><rights>Copyright © 2009 Weimann et al. 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2795372/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2795372/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20049072$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weimann, A</creatorcontrib><creatorcontrib>Ebener, Ch</creatorcontrib><creatorcontrib>Holland-Cunz, S</creatorcontrib><creatorcontrib>Jauch, K W</creatorcontrib><creatorcontrib>Hausser, L</creatorcontrib><creatorcontrib>Kemen, M</creatorcontrib><creatorcontrib>Kraehenbuehl, L</creatorcontrib><creatorcontrib>Kuse, E R</creatorcontrib><creatorcontrib>Laengle, F</creatorcontrib><creatorcontrib>Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine</creatorcontrib><title>Surgery and transplantation - Guidelines on Parenteral Nutrition, Chapter 18</title><title>German medical science</title><addtitle>Ger Med Sci</addtitle><description>In surgery, indications for artificial nutrition comprise prevention and treatment of catabolism and malnutrition. Thus in general, food intake should not be interrupted postoperatively and the re-establishing of oral (e.g. after anastomosis of the colon and rectum, kidney transplantation) or enteral food intake (e.g. after an anastomosis in the upper gastrointestinal tract, liver transplantation) is recommended within 24 h post surgery. To avoid increased mortality an indication for an immediate postoperatively artificial nutrition (enteral or parenteral nutrition (PN)) also exists in patients with no signs of malnutrition, but who will not receive oral food intake for more than 7 days perioperatively or whose oral food intake does not meet their needs (e.g. less than 60-80%) for more than 14 days. In cases of absolute contraindication for enteral nutrition, there is an indication for total PN (TPN) such as in chronic intestinal obstruction with a relevant passage obstruction e.g. a peritoneal carcinoma. If energy and nutrient requirements cannot be met by oral and enteral intake alone, a combination of enteral and parenteral nutrition is indicated. Delaying surgery for a systematic nutrition therapy (enteral and parenteral) is only indicated if severe malnutrition is present. Preoperative nutrition therapy should preferably be conducted prior to hospital admission to lower the risk of nosocomial infections. The recommendations of early postoperative re-establishing oral feeding, generally apply also to paediatric patients. Standardised operative procedures should be established in order to guarantee an effective nutrition therapy.</description><subject>fast track surgery</subject><subject>Germany</subject><subject>Humans</subject><subject>Nutrition Disorders - etiology</subject><subject>Nutrition Disorders - prevention & control</subject><subject>Parenteral Nutrition - methods</subject><subject>Parenteral Nutrition - standards</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - therapy</subject><subject>postoperative nutrition</subject><subject>Practice Guidelines as Topic</subject><subject>surgery</subject><subject>transplantation</subject><subject>Transplantation - adverse effects</subject><issn>1612-3174</issn><issn>1612-3174</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVkUtLxDAQx4Mour4-gvTmxWomj6a9CLLourCooPcwTae7kW67pq3gtzc-0bnMk9-fmWHsGPi5FFxf8GhZscUmkIFIJRi1_SfeY_t9_8y5FDLju2xPcK4KbsSELR7HsKTwlmBbJUPAtt802A44-K5N0mQ2-ooa31KfxPwBA7UDBWySu3EI_mPoLJmucBOLCeSHbKfGpqejb3_Anm6un6a36eJ-Np9eLdJKqGxIEUByhzUorrOaeKl4rjNZCpS5AXC6KBzqHIGjjFYrk9cIVSYpN6RQHrD5F7bq8Nlugl9jeLMdevtZ6MLSYhi8a8gSQSm1y1wNoExJOUdXFKoUZV1o4arIuvxibcZyTZWL-8X1_kH_d1q_ssvu1QpTaGlEBJx-A0L3MlI_2LXvHTXxitSNvTVSCQGg8zh58lfqV-PnGfId4A6J0w</recordid><startdate>20091118</startdate><enddate>20091118</enddate><creator>Weimann, A</creator><creator>Ebener, Ch</creator><creator>Holland-Cunz, S</creator><creator>Jauch, K W</creator><creator>Hausser, L</creator><creator>Kemen, M</creator><creator>Kraehenbuehl, L</creator><creator>Kuse, E R</creator><creator>Laengle, F</creator><general>German Medical Science GMS Publishing House</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20091118</creationdate><title>Surgery and transplantation - Guidelines on Parenteral Nutrition, Chapter 18</title><author>Weimann, A ; 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subjects | fast track surgery Germany Humans Nutrition Disorders - etiology Nutrition Disorders - prevention & control Parenteral Nutrition - methods Parenteral Nutrition - standards Postoperative Complications - etiology Postoperative Complications - therapy postoperative nutrition Practice Guidelines as Topic surgery transplantation Transplantation - adverse effects |
title | Surgery and transplantation - Guidelines on Parenteral Nutrition, Chapter 18 |
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