| PERIOPERATIVE NUTRITIONAL MANAGEMENT OF PATIENTS UNDERGOING LAPAROTOMY
| M. I. Toulson Davisson Correia, P. Costa Fonseca, G. A. Machado Cruz
| Nutr Hop. 2009;24(4):479-484
| PDF (79,5kb)
| Objectives: Lack of routine patient’s nutritional assessment
and prescription of long fasting periods throughout
the perioperative period are still widely prevalent despite
the advances in surgical care. Therefore, the aim of this
study was to assess nutritional routines in two surgical
Methods: Adult patients undergoing laparotomy at two
distinct units (gastrointestinal and gynecologic) in two
public hospitals (one of them a university) were enrolled.
Patients were divided in minor and major (groups A and
B) procedures and were nutritionally assessed at admission.
Daily diet intake and a 24 hour recall were performed.
Patients rated the quality of the meals, as well as
registered the reasons for not ingesting it fully.
Results: Patients in group B presented with poorer
nutritional status. Group A patients resumed oral diets
on the first post operative day and most of them received
regular diets (85.5%). In group B, only 4.7% were
allowed a regular diet on the first PO day, 7.0% received
soft diets, 30.2% full liquid diets, 27.9% clear liquids and
the remaining 30.2% were on NPO. Patients in this group
had a slower progression of diets from liquid to regular
solid meals, with 7% of them still on NPO on the fifth PO
day. Contrary to group B, patients in group A did not present
with cumulative caloric and protein deficits throughout
the postoperative period. Overall tolerance of the
early diet was good.
Conclusion: Malnutrition is still high among major
surgical patients. Early oral nutrition can be feasible and
well tolerated with few side effects, when prescribed.