Should perioperative immunonutrition for elective surgery be the current standard of care?

作     者：Shishira Bharadwaj Brandon Trivax Parul Tandon Bilal Alkam Ibrahim Hanouneh Ezra Steiger 

作者机构：Center for Human Nutritionthe Cleveland Clinic FoundationClevelandOHUSA College of Osteopathic MedicineMichigan State UniversityEast LansingMIUSA 

出 版 物：《Gastroenterology Report》 (胃肠病学报道（英文）)

年 卷 期：2016年第4卷第2期

页      面：87-95,I0001页

核心收录：

学科分类：1011[医学-护理学（可授医学、理学学位）] 10[医学] 

主　　题：immunonutrition infections postoperative complications cost-effectiveness guidelines 

摘      要：Postoperative infectious complications are independently associated with increased hospital length of stay(LOS)and cost and contribute to significant inpatient *** strategies such as avoidance of long periods of preoperative fasting,re-establishment of oral feeding as early as possible after surgery,metabolic control and early mobilization have been used to either prevent or reduce the incidence of postoperative *** these efforts,it remains a big challenge to our current healthcare system to mitigate the cost of postoperative ***,preoperative nutritional status has also been implicated as an independent risk factor for postoperative *** nutritional support using enteral and parenteral routes has been shown to decrease postoperative morbidity,especially in high-risk ***,the role of immunonutrition(IMN)in postoperative infectious complications has been studied *** substrates have been found to positively modulate postsurgical immunosuppression and inflammatory *** have also been shown to be cost-effective by decreasing both tpostoperative infectious complications and hospital *** this review,we discuss the postoperative positive outcomes associated with the use of perioperative IMN,their cost-effectiveness,current guidelines and future clinical implications.