P28.02 Individualized Nutritional Management in Patients Eligible for Thoracic Surgery Experience of a Chest Tumor Center in Brazil

Abstract

Lung cancer (LC) has an increased incidence and early diagnosis can be instituted as a curative measure for these patients. Surgery is the treatment of choice for early-stage disease, which can be combined with systemic treatment. The personalized nutritional intervention in these patients can contribute to an adequate pre and postoperative and subsequent chemotherapy treatment. Research in these areas is necessary to establish a diet that will guarantee an adequate caloric and protein intake in these patients in order to preserve nutritional status and quality of life. The objective is to describe an experience report of a nutritional intervention protocol applied pre- and postoperatively in patients undergoing thoracic surgery at a referral center. This is a qualitative, descriptive, experience report type study carried out in an oncology clinic. The protocol used in the unit consists of the application of nutritional risk tracking instruments, the Patient-Generated Subjective Global Assessment (PG-SGA) and subsequent assessment of nutritional status by anthropometric methods (weight, history of weight loss, height, body mass, calf perimeter, food history (24-hour recall for 3 consecutive days), laboratory tests (blood count, blood glucose, glycosylated hemoglobin, albumin, protein C reactive) and comorbidities. with nutritional risk, considered in our center as patients with unintentional weight loss, low force palm pressure by dynamometry according to the European Working Group on Sarcopenia in Older People (EWGSOP), low protein intake according to the guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) and American Society for Parenteral and Enteral Nutrition (ASPEN). Patients at high risk of malnutrition are chosen to receive immunomodulatory nutritional therapy between 7 and 14 days pre- and postoperatively, as shown in figure 1. Adequate nutritional status appears to be achieved when this protocol is completed. The referral of patients with chest tumors eligible for surgery to nutrition, allows an early and more effective nutritional intervention. Having this flow as a service routine allows the patient a better response to treatment and a positive impact on their quality of life.