Nutrition preoperative

Preoperative nutrition support in patients with moderate to severe malnutrition who cannot tolerate enteral nutrition and in whom surgery can be delayed safely for at least 7 days... 

Chronic liver diseases, especially cirrhosis and alcohol-induced conditions, are accompanied by malnutrition in 50-80% of cases. The prognosis of the liver disease largely depends on the nutritional state - there is also a direct relationship between the probability of survival after liver transplantation and preoperative malnutrition. (17, 19, 20, 23 - 27, 29, 32)... 

The majority of pre-OLT nutrition intervention studies demonstrate a morbidity benefit post-OLT (per anthropometric tests, hospital stay, and postoperative infections), but typically fail to demonstrate a mortality benefit that reaches statistical significance (although this may be due to small sample sizes). Preoperative obesity is known to increase morbidity, and in some studies, mortality perioperatively. It is for these reasons that some centers consider... 

Many patients in intensive care units receive intravenous nutrition, which is a mixture of various amino acids, sorbitol, and ethanol. In a study of 30 patients with normal preoperative folate levels who were operated on for gastrointestinal disease, the serum folate fell within 48 hours by 60-95% in 20 patients receiving intravenous nutrition (W24). Seven patients had a megaloblastic bone marrow. Daily treatment with 0.5 mg of folic acid given intravenously prevented any clinical signs of folate deficiency. These patients received between 100 and 150 g of ethanol daily as part of their parenteral nutrition, and this may have played a significant role in the development of folate deficiency. However, Tennant (T12) examined this possibility and found that acute depression of the serum folate concentration occurred with both alcohol-firee and alcohol-containing preparations used for parenteral nutrition. It was also noted that only one particular brand of... 

T12. Tennant, G. B., Smith, R. C., Leinster, S. J., O Donnell, J. E., and Wardrop, A. J., Acute depression of serum folate in surgical patients during preoperative iniusion of ethanol-fiee parental nutrition. Scand. J. Haematol. 27, 327-332 (1981). 

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