French clinical guidelines on perioperative nutrition. Update of the 1994 consensus conference on perioperative artificial nutrition for elective surgery in adults
C Chambrier, F Sztark, Société Francophone de nutrition clinique et métabolisme (SFNEP), Société française d’anesthésie et réanimation (SFAR), Cécile Chambrier, Sébastien Pierre, Xavier Alacoque, Patrick Bachmann, Jacques Berre, Isabelle Bourdel-Marchasson, Dominique Caldari, Patrick Chardon, Virginie Colomb, Pauline Coti-Bertrand, Daniel Francon, Elena Paillaud, André Petit, Noël Peretti, Sébastien Pierre, Marie-Astrid Piquet, Didier Quillot, Marc Raucoules-Aimé, Agathe Raynaud-Simon, Pierre Senesse, Ronan Thibault, Jean Fabien Zazzo, C Chambrier, F Sztark, Société Francophone de nutrition clinique et métabolisme (SFNEP), Société française d’anesthésie et réanimation (SFAR), Cécile Chambrier, Sébastien Pierre, Xavier Alacoque, Patrick Bachmann, Jacques Berre, Isabelle Bourdel-Marchasson, Dominique Caldari, Patrick Chardon, Virginie Colomb, Pauline Coti-Bertrand, Daniel Francon, Elena Paillaud, André Petit, Noël Peretti, Sébastien Pierre, Marie-Astrid Piquet, Didier Quillot, Marc Raucoules-Aimé, Agathe Raynaud-Simon, Pierre Senesse, Ronan Thibault, Jean Fabien Zazzo
Abstract
Surgical patient is a stressed patient. Aggression is more intense and prolonged as surgery is important. Surgery induces secretion of stress hormones, inflammatory mediators and metabolic changes resulting in significant catabolic phenomena. The presence of malnutrition is an independent risk factor for postoperative complications. Malnutrition increases morbidity (infections, delayed healing), mortality, length of stay and costs and impacts human quality of life for patients. It has been shown that the management of perioperative malnutrition reduces the additional risk generated by it. Perioperative nutritional support should not be systematically provided. Since 1994, recommendations on perioperative nutrition, the care of patients and the available resources have changed dramatically. An update of these recommendations was needed. In 2010, an expert panel of the French society of Anesthesiology (SFAR) and the French-speaking society of Clinical Nutrition and Metabolism (SFNEP) has made recommendations for good clinical practice of perioperative nutrition. They are presented. Thus, the perioperative nutritional management must be integrated in a process to reduce the operative risk: risk reduction due to preoperative malnutrition, reduced risk of postoperative malnutrition which may compromise the following treatments, reduction of postoperative metabolic complications, reducing the postoperative morbidity, especially infectious, through the use of pharmaconutrients either preoperatively or postoperatively in some patients.
Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Source: PubMed