Perioperative nutritional support. Russian Federation of anesthesiologists and reanimatologists guidelines

I.N. Leyderman, A.I. Gritsan, I.B. Zabolotskikh, S.V. Lomidze, V.A. Mazurok, I.V. Nekhaev, E.M. Nikolaenko, A.V. Nikolenko, I.V. Poliakov, A.V. Sytov, A.I. Yaroshetskiy

Russian Federation of Anesthesiologists and Reanimatologists

For correspondence: Leyderman Ilya Naumovich — Chair of Anesthesiology, Critical Care and Transfusiology, Ural State Medical University, Ekaterinburg; e-mail: inl230970@gmail.com

For citation: Leyderman IN, Gritsan AI, Zabolotskikh IB, Lomidze SV, Mazurok VA, Nekhaev IV, Nikolaenko EM, Nikolenko AV, Poliakov IV, Sytov AV, Yaroshetskiy AI. Perioperative nutritional support. Russian Federation of anesthesiologists and reanimatologists guidelines. Alexander Saltanov Intensive Care Herald. 2018;3:5–21.

DOI: 10.21320/1818-474X-2018-3-5-21


Malnutrition among surgical patients is rather common problem. The degree and severity of malnutrition after surgery significantly correlates with the length of stay in the intensive care unit and surgical hospital, rate of infectious complications development, unsatisfactory results of treatment and increased costs. The presented clinical recommendations clarifies key methods for the prevention of development, diagnosis and treatment of the protein-energy malnutrition (PEM) syndrome in the pre and postoperative period. The choice of methods for diagnosis and PEM correction during the perioperative period is based on studies evaluated from the endpoints of evidence-based medicine. In applications, key quality criteria for treatment, as well as algorithms of actions in the preoperative and postoperative period are presented.

Keywords: preoperative period, postoperative period, protein-energy malnutrition, nutritional status, parenteral nutrition, enteral nutrition, nutritional support

Received: 20.08.2018


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Modern Approaches to Perioperative Nutritional Support in Oncology

A.E. Shestopalov

GBOU DPO «Russian Medical Academy of Postgraduate Education» The Ministry of Health of the Russian Federation, Moscow

For citation: Shestopalov AE. Modern Approaches to Perioperative Nutritional Support in Oncology. Intensive Care Herald. 2016;2:5–14.


Malnutrition in patients with cancer is the result of gross metabolic disorders, cachexia and anorexia associated with tumor necrosis factor. Metabolic disorders include disorders ofcarbohydrate, protein, lipid metabolism and enzymatic components that increase energy requirements and deficiency of essential nutrients. In addition, considerable importance in the formation of a nutrient deficiency is the local influence of the tumor — destructive processes, compression or destruction of surrounding tissue and organs. The special features of metabolic disorders and malnutrition in cancer patients should include immunosuppression, which is a negative prognostic factor for the outcome ofsurgical treatment.

Along with preoperative nutritional deficiency metabolic response to surgical trauma has significant effect on the postoperative course and results of surgical treatment. Catabolic type metabolism in combination with morphological and functional lesions of the gastrointestinal tract (intestinal distress syndrome) is characterized by the development of protein-energy malnutrition (PEM), nutritional status violation and impossibility of providing the body with nutrients naturally. In turn, malnutrition and active proteolysis contribute to slowing down regenerative processes, wound healing, cell differentiation and disorders of the immune system increasing the risk of infectious complications.

The current situation in recent years, the concept of nutritional support in surgical patients is intended to sinclude enteral and parenteral nutrition (glutamine, arginine, omega-3 fatty acids).

Keywords: nutritional support, cancer patients, protein-energy malnutrition

Received: 16.06.2016


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