3 - Nutritional status and requirements

Abstract

The nutritional status of surgical patients has been shown to impact outcomes since the classical study by Studley (Studley, 1936), in which he showed that patients who had lost more than 20% of the usual body weight before peptic ulcer surgery presented with increased mortality. Several studies enrolling patients who undergo different surgical procedures have corroborated this observation, and although no clinical randomized study has been carried out, which would be absolutely unethical, the relationship between the nutritional status and morbidity, mortality, costs, and length of hospital stay has been well shown. Therefore, it is highly recommended that patients who will undergo surgery, in particular, complex procedures, should be nutritional screened and assessed. If the patient is malnourished, nutrition therapy, while preparing the patient for the surgical act, should be carried out. The goal of nutrition therapy in surgical patients is specially directed to the provision of substrates for the body to be able to adequately face the organic response and also to improve wound healing. In this regard, it is not expected to have the patient fully recover his/her previous nutritional status and also to gain weight by recovering body compartments. This happens late in the course of nutritional replenishment with updated assessment of the requirements. In this regard, it is noteworthy to point out that the nutritional requirements should be individually tailored according to the nutritional and metabolic status of the patient.