RT Book, Section
A1 Shary, Thomas M.
A1 Chapman, Emily A.
A1 Herrmann, Virginia M.
A2 Doherty, Gerard M.
SR Print(0)
ID 1105484718
T1 Surgical Metabolism & Nutrition
T2 CURRENT Diagnosis & Treatment: Surgery, 14e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071792110
LK accessmedicine.mhmedical.com/content.aspx?aid=1105484718
RD 2024/04/18
AB The  effects  of  malnutrition  on  the  surgical  patient  are  well  characterized  in  the  literature  but  are  often  overlooked  in  the  clinical  arena.  Between  30%  and  50%  of  hospitalized  patients  are  malnourished.  Protein-calorie  malnutrition  produces  a  reduction  in  lean  muscle  mass,  alterations  in  respiratory  mechanics,  impaired  immune  function,  and  intestinal  atrophy.  These  changes  result  in  diminished  wound  healing,  predisposition  to  infection,  and  increased  postoperative  morbidity.  Although  most  healthy  individuals  can  tolerate  up  to  7  days  of  starvation  (with  adequate  glucose  and  fluid  replacement),  those  subjected  to  major  trauma,  the  physiologic  stress  of  surgery,  sepsis,  or  cancer-related  cachexia  require  earlier  nutritional  intervention.  Methods  to  identify  those  at  greatest  need  for  supplemental  nutrition  and  to  adequately  address  their  needs  are  discussed  in  this  chapter.