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Optimizing Perioperative Nutrition in Pediatric Populations
Author(s) -
Canada Nicki L.,
Mullins Lucille,
Pearo Brittany,
Spoede Elizabeth
Publication year - 2016
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533615622639
Subject(s) - medicine , parenteral nutrition , perioperative , malnutrition , clinical nutrition , ileus , pediatric surgery , intensive care medicine , artificial nutrition , postoperative ileus , surgery
Nutrition status prior to surgery and nutrition rehabilitation after surgery can affect the morbidity and mortality of pediatric patients. A comprehensive approach to nutrition in pediatric surgical patients is important and includes preoperative assessment, perioperative nutrition considerations, and postoperative recovery. A thorough nutrition assessment to identify patients who are at nutrition risk prior to surgery is important so that the nutrition status can be optimized prior to the procedure to minimize suboptimal outcomes. Preoperative malnutrition is associated with increased complications and mean hospital days following surgery. Enteral and parenteral nutrition can be used in cases where food intake is inadequate to maintain and possibly improve nutrition status, especially in the 7−10 days prior to surgery. In the perioperative period, fasting should be limited to restricting solid foods and non–human milk 6 hours prior to the procedure and allowing clear liquids until 2 hours prior to the procedure. Postoperatively, early feeding has been shown to resolve postoperative ileus earlier, decrease infection rates, promote wound healing, and reduce length of hospital stay. If nutrition cannot be provided orally, then nutrition through either enteral or parenteral means should be initiated within 24–48 hours of surgery. Practitioners should identify those patients who are at the highest nutrition risk for postsurgical complications and provide guidance for optimal nutrition during the perioperative and postoperative period.