Аннотация
Многочисленные публикации указывают, что, в зависимости от вида патологии, белково-энергетическая недостаточность (БЭН) развивается у 20–50 % хирургических пациентов непосредственно в стационаре в ран- нем послеоперационном периоде. Достаточно большое количество пациентов с хирургической патологией уже госпитализируются в стационары с различной степенью нутритивной недостаточности. От 30 до 69 % больных поступают в клинику с БЭН I–III степени и нуждаются в обязательном проведении нутритивной поддержки. Факторы риска развития БЭН выявляют у 60–70 % госпитализированных. В методических рекомендациях представлены основные принципы проведения нутритивной поддержки в периоперационном периоде.Библиографические ссылки
- Луфт В.М., Афончиков В.С., Дмитриев А.В. и др. Руководство по клиническому питанию: руководство. СПб.: Арт-Экспресс, 2016. [Luft V.M., Afonchikov V.S., Dmitriev A.V., et al. Clinical nutrition manual. SPb.: Art-Express, 2016. (In Russ)]
- Kondrup J., Allison S.P., Elia M., et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003; 22(4): 415–21. DOI: 10.1016/s0261-5614(03)00098-0
- Lobo D.N., Gianotti L., Adiamah A., et al. Perioperative nutrition: Recommendations from the ESPEN expert group. Clin Nutr. 2020; 39(11): 3211–27. DOI: 10.1016/j.clnu.2020.03.038
- Энтеральное и парентеральное питание: национальное руководство / под ред. А.И. Салтанова, Т.С. Поповой. М.: ГЭОТАР-Медиа, 2014. [Enteral and parenteral nutrition: national guidance / eds. A.I. Saltanov, T.S. Popova. M.: GEOTAR-Media, 2014. (In Russ)]
- Bozzetti F. Chemotherapy-Induced Sarcopenia. Curr Treat Options Oncol. 2020; 21(1): 7. DOI: 10.1007/s11864-019-0691-9
- Салтанов А.И., Сельчук В.И., Снеговой А.В. Основы нутритивной поддержки в онкологической клинике (руководство для врачей). М.: МЕДпресс-информ, 2009. [Saltanov A.I., Selchuk V.I., Snegovoy A.V. Fundamentals of Nutritional Support in a Cancer Clinic (A Guide for Physicians). M.: MEDpress-inform, 2009. (In Russ)]
- Arends J., Bachmann P., Baracos V., et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017; 36(1): 11–48. DOI: 10.1016/j.clnu.2016.07.015
- Клинические рекомендации. Анестезиология-реаниматология/ Под. ред. И.Б. Заболотских, Е.М. Шифмана. М.: ГЭОТАР-Медиа, 2016. [Clinical guidelines. Anesthesiology-resuscitation. Eds.: I.B. Zabolotskikh, E.M. Shifman. M.: GEOTAR-Media, 2016. (In Russ)]
- Charlton K., Nichols C., Bowden S., et al. Poor nutritional status of older subacute patients predicts clinical outcomes and mortality at 18 months of follow-up. Eur J Clin Nutr. 2012; 66(11): 1224–8. DOI: 10.1038/ejcn.2012.130
- Weimann A., Braga M., Carli F., et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017; 36(3): 623:650. DOI: 10.1016/j.clnu.2017.02.013
- Sun Z., Kong X.J., Jing X., et al. Nutritional Risk Screening 2002 as a Predictor of Postoperative Outcomes in Patients Undergoing Abdominal Surgery: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. PLoS One. 2015; 10(7): 0132857. DOI: 10.1371/journal.pone.0132857
- Shachar S.S., Williams G.R., Muss H.B., Nishijima T.F. Prognostic value of sarcopenia in adults with solid tumours: A metaanalysis and systematic review. Eur J Cancer. 2016; 57: 58–67. DOI: 10.1016/j.ejca.2015.12.030
- Kuwada K., Kuroda S., Kikuchi S., et al. Clinical Impact of Sarcopenia on Gastric Cancer. Anticancer Res. 2019; 39(5): 2241–9. DOI: 10.21873/anticanres.13340
- Järvelä K., Maaranen P., Sisto T. Pre-operative oral carbohydrate treatment before coronary artery bypass surgery. Acta Anaesthesiol Scand. 2008; 52(6): 793–7. DOI: 10.1111/j.1399-6576.2008.01660.x
- Wang Z.G., Wang Q., Wang W.J., Qin H.L. Randomized clinical trial to compare the effects of preoperative oral carbohydrate versus placebo on insulin resistance after colorectal surgery. Br J Surg. 2010; 97(3): 317–27. DOI: 10.1002/bjs.6963
- Gustafsson U.O., Scott M.J., Schwenk W., et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations. Clin Nutr. 2012; 31(6): 783–800. DOI: 10.1016/j.clnu.2012.08.013
- Gianotti L., Biffi R., Sandini M., et al. Preoperative oral carbohydrate load versus placebo in major elective abdominal surgery (PROCY): a randomized, placebo-controlled, multicenter, phase III trial. Ann Surg. 2018; 267(4): 623–30. DOI: 10.1097/SLA.0000000000002325
- Kaska M., Grosmanova T., Havel E., et al. The impact and safety of preoperative oral or intravenous carbohydrate administration versus fasting in colorectal surgery—a randomized controlled trial. Wien Klin Wochenschr. 2010; 122(1–2): 23–30. DOI: 10.1007/s00508-009-1291-7
- Elia M., Normand C., Norman K., Laviano A. A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in the hospital setting. Clin Nutr. 2016; 35(2): 370– 80. DOI: 10.1016/j.clnu.2015.05.010
- Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017; 126(3): 376–93. DOI: 10.1097/ALN.0000000000001452
- Потапов А.Л. Дополнительное пероральное питание в составе нутритивной поддержки в онкохирургии. Вестник анестезиологии и реаниматологии. 2020; 17(2): 64–69. DOI:10.21292/2078-5658-2020-17-2-64-69 [Potapov A.L. Oral nutritional supplements in nutrition support for cancer surgery. Messenger of anesthesiology and resuscitation. 2020; 17(2): 64–9. (In Russ.)]
- Charlton K., Nichols C., Bowden S., et al. Poor nutritional status of older subacute patients predicts clinical outcomes and mortality at 18 months of follow-up. Eur J Clin Nutr. 2012; 66(11): 1224–8. DOI: 10.1038/ejcn.2012.130
- Osland E., Yunus R.M., Khan S., Memon M.A. Early versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery: a meta-analysis. JPEN. 2011; 35(4): 473–87. DOI: 10.1177/0148607110385698
- Dizdar O.S., Baspınar O., Kocer D., et al. Nutritional Risk, Micronutrient Status and Clinical Outcomes: A Prospective Observational Study in an Infectious Disease Clinic. Nutrients. 2016; 8(3): 124. DOI: 10.3390/nu8030124
- Barker L.A., Gray C., Wilson L., et al. Preoperative immunonutrition and its effect on postoperative outcomes in well-nourished and malnourished gastrointestinal surgery patients: a randomized controlled trial. Eur J Clin Nutr. 2013; 67(8): 802–7. DOI: 10.1038/ejcn.2013.117
- Bharadwaj S., Trivax B., Tandon P., et al. Should perioperative immunonutrition for elective surgery be the current standard of care? Gastroenterology Report. 2016; 4(2): 87–95. DOI: 10.1093/gastro/gow008
- Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. Perioperative total parenteral nutrition in surgical patients. N Engl J Med. 1991; 325(8): 525–32. DOI: 10.1056/NEJM199108223250801
- Bozzetti F., Gavazzi C., Miceli R., et al. Perioperative total parenteral nutrition in malnourished, gastrointestinal cancer patients: a randomized, clinical trial. J Parenteral Enteral Nutr. 2000; 24(1):7–14. DOI: 10.1177/014860710002400107
- Fukuda Y., Yamamoto K., Hirao M., et al. Prevalence of malnutrition among gastric cancer patients undergoing gastrectomy and optimal preoperative nutritional support for preventing surgical site infections. Ann Surg Oncol. 2015; 22(Suppl 3): S778–85. DOI: 10.1245/s10434-015-4820-9
- Gerritsen A., Besselink M.G., Gouma D.J., et al. Systematic review of five feeding routes after pancreatoduodenectomy. Br J Surg. 2013; 100(5): 589–98. DOI: 10.1002/bjs.9049
- Adiamah A., Ranat R., Gomez D. Enteral versus parenteral nutrition following pancreaticoduodenectomy: a systematic review and meta-analysis. HPB (Oxford). 2019; 21(7): 793–801. DOI: 10.1016/j.hpb.2019.01.005
- Lee S.H., Jang J.Y., Kim H.W., et al. Effects of early enteral nutrition on patients after emergency gastrointestinal surgery: a propensity score matching analysis. Medicine (Baltim). 2014; 93(28): 323. DOI: 10.1097/MD.0000000000000323
- Herbert G., Perry R., Andersen H.K., et al. Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications. Cochrane Database Syst Rev. 2018; 10(10):CD004080. DOI: 10.1002/14651858
- Затевахин И.И., Пасечник И.Н., Ачкасов С.И. и др. Клинические рекомендации по внедрению программы ускоренного выздоровления пациентов после плановых хирургических вмешательств на ободочной кишке. Доктор.Ру. Анестезиология и реаниматология. Мед. реабилитация. 2016;12–1(129): 8–21. [Zatevakhin I.I., Pasechnik I.N., Achkasov S.I., et al. Clinical Guidelines on Implementation of Enhanced-Recovery-After-Surgery Program for Elective Colorectal Surgery. Doctor.ru. Anesthesiology and Critical Care Medicine. 2016; 12–1(129): 8–21. (In Russ)]
- Carmichael J.C., Keller D.S., Baldini G., et al. Clinical Practice Guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons. Dis. Colon. Rectum. 2017; 60(8): 761–84. DOI: 10.1097/DCR.0000000000000883
- Лейдерман И.Н., Ярошецкий А.И. К вопросу о потребности в белке пациентов отделений реанимации и интенсивной терапии. Вестник интенсивной терапии им. А.И. Салтанова. 2018; 3: 59–66. DOI: 10.21320/1818–474X-2018-3-59-66 [Leyderman I.N., Yaroshetskiy A.I. Discussing protein requirements of intensive care UNIT (ICU) patients. Alexander Saltanov Intensive Care Herald. 2018; 3: 59–66. (In Russ)]
- Leyderman I., Yaroshetskiy A., Klek S. Protein requirements in critical illness: do we really know why to give so much? Journal of Parenteral and Enteral Nutrition. 2020; 44(4): 589–98. DOI: 10.1002/jpen.1792
- Gianotti L., Braga M., Vignali A., et al. Effect of route of delivery and formulation of postoperative nutritional support in patients undergoing major operations for malignant neoplasms. Arch Surg. 1997; 132(11): 1222–9.
- Zhu X., Wu Y., Qiu Y., et al. Comparative analysis of the efficacy and complications of nasojejunal and jejunostomy on patients undergoing pancreaticoduodenectomy. J Parenter Enteral Nutr. 2014; 38(8): 996–1002. DOI: 10.1177/0148607113500694
- Sica G.S., Sujendran V., Wheeler J., et al. Needle catheter jejunostomy at esophagectomy for cancer. J Surg Oncol. 2005; 91(4): 276–9. DOI: 10.1002/jso.20314
- Chin K.F., Townsend S., Wong W., Miller G.V. A prospective cohort study of feeding needle catheter jejunostomy in an upper gastrointestinal surgical unit. Clin Nutr. 2004; 23(4): 691–6. DOI: 10.1016/j.clnu.2003.11.002
- Ramamurthy A., Negi S.S., Chaudhary A. Prophylactic tube jejunostomy: a worthwhile undertaking. Surg Today. 2008; 38(5):420–4. DOI: 10.1007/s00595-007-3650-1
- Siow S.L., Mahendran H.A., Wong C.M., et al. Laparoscopic T-tube feeding jejunostomy as an adjunct to staging laparoscopy for upper gastrointestinal malignancies: the technique and review of outcomes.BMC Surg. 2017; 17(1): 25. DOI: 10.1186/s12893-017-0221-2
- Lien H.C., Chang C.S., Chen G.H. Can percutaneous endoscopic jejunostomy prevent gastroesophageal reflux in patients with preexisting esophagitis? Am J Gastroenterol. 2000; 95(12): 3439–43. DOI: 10.1111/j.1572-0241.2000.03281.x
- Heidegger C.P., Berger M.M., Graf S., et al. Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: a randomised controlled clinical trial. Lancet. 2013; 381(9864): 385–93. DOI: 10.1016/S0140-6736(12)61351-8
- Pichard C., Schwarz G., Frei A., et al. Economic investigation of the use of three-compartment total parenteral nutrition bag: prospective randomized unblinded controlled study. Clin Nutr. 2000; 19(4): 245–51. DOI: 10.1054/clnu.2000.0106
- Menne R., Adolph M., Brock E., et al. Cost analysis of parenteral nutrition regimens in the intensive care unit: three-compartment bag system vs multibottle system. J Parenter Enteral Nutr. 2008; 32(6): 606–12. DOI: 10.1177/0148607108322404
- Turpin R.S., Canada T., Rosenthal V., et al. IMPROVE Study Group. Bloodstream infections associated with parenteral nutrition preparation methods in the United States: a retrospective, large database analysis. J Parenter Enteral Nutr. 2012; 36(2): 169–76.
- Adolph M. Lipid emulsions in total parenteral nutrition-state of the art and future perspectives. Clinical Nutrition. 2001; 20(S4):11–4.
- Grau T., Ruiz de Adana J., Zubillaga S., et al. Randomized study of two different fat emulsions in total parenteral nutrition of malnourished surgical patients; effect of infectious morbidity and mortality. Nutr Hosp. 2003; 18: 159–66.
- Sadu Singh B.K.S., Narayanan S.S., Khor B.H., et al. Composition and Functionality of Lipid Emulsions in Parenteral Nutrition: Examining Evidence in Clinical Applications. Front Pharmacol. 2020; 11: 506. DOI: 10.3389/fphar.2020.00506
- Faucher M., Bregeon F., Gainnier M., et al. Cardiopulmonary Effects of Lipid Emulsions in Patients With ARDS. Chest. 2003; 124: 285–291.
- Jiang Z., Jiang H. The clinical efficacy of glutamine dipeptides on postoperative patients: an updated systematic review of randomized controlled trials from Europe and Asia (1997–2005). Zhonghua Yi Xue Za Zhi. 2006; 86(23): 1610–4.
- Wang Y., Jiang Z.M., Nolan M.T., et al. The impact of glutamine dipeptide-supplemented parenteral nutrition on outcomes of surgical patients: a meta-analysis of randomized clinical trials. J Parenter Enteral Nutr. 2010; 34(5): 521–9. DOI: 10.1177/0148607110362587
- Bollhalder L., Pfeil A.M., Tomonaga Y., Schwenkglenks M. A systematic literature review and meta-analysis of randomized clinical trials of parenteral glutamine supplementation. Clin Nutr. 2013; 32(2): 213–23.
- Sandini M., Nespoli L., Oldani M., et al. Effect of glutamine dipeptide supplementation on primary outcomes for elective major surgery: systematic review and meta-analysis. Nutrients. 2015; 7(1): 481– 99. DOI: 10.3390/nu7010481
- Perez-Barcena J., Marce P., Zabalegui-Pérez A., et al. A randomized trial of intravenous glutamine supplementation in trauma ICU patients. Intensive Care Med. 2014; 40(4): 539–47. DOI: 10.1007/s00134-014-3230-y
- Ziegler T.R., May A.K., Hebbar G., et al. Efficacy and safety of glutamine-supplemented parenteral nutrition in surgical ICU patients: an American multicenter randomized controlled trial. Ann Surg. 2016; 263(4): 646–55. DOI: 10.1097/SLA.0000000000001487
- Andrews P.J.D., Avenell A., Noble D.W., et al. Randomized trial of glutamine, selenium, or both, to supplemental parenteral nutrition for critically ill patients. BMJ. 2011; 342: 1542.
- Heyland D., Muscedere J., Wischmeyer P.E., et al. A randomized trial of glutamine and antioxidants in critically ill patients. N Engl J Med. 2013; 368(16): 1489–97. DOI: 10.1056/NEJMoa1212722
- Cui Y., Hu L., Liu Y., et al. Intravenous alanyl-L-glutamine balances glucose-insulin homeostasis and facilitates recovery on patients undergoing colonic resection—a randomised trial. Eur J Anaestesiol. 2014; 31: 212–8. DOI: 10.1097/EJA.0b013e328360c6b9
- Wang Y., Jiang Z.M., Nolan M.T., et al. The impact of glutamine dipeptide-supplemented parenteral nutrition on outcomes of surgical patients: a meta-analysis of randomized clinical trials. J Parenter Enteral Nutr. 2010; 34: 521–9. DOI: 10.1177/0148607110362587
- Bollhalder L., Pfeil A.M., Tomonaga Y., Schwenkglenks M. A systematic literature review and meta-analysis of randomized clinical trials of parenteral glutamine supplementation. Clin Nutr. 2013; 32: 213–23. DOI: 10.1016/j.clnu.2012.11.003
- Novak F., Heyland D.K., Avenell A., et al. Glutamine supplementation in serious illness: a systematic review of the evidence. Crit Care Med. 2002; 30(9): 2022–9. DOI: 10.1097/00003246-200209000-00011
- Wichmann M.W., Thul P., Czarnetzki H.-D., et al. Evaluation of clinical safety and beneficial effects of a fish oil containing lipid emulsion (MLF 541): Data from a prospective, randomized, multicenter trial. Crit Care Med. 2007; 35(3): 700–6. DOI: 10.1097/01.CCM.0000257465.60287.AC
- Grau-Carmona T., Bonet-Saris A., Abelardo G.L., et al. Influence of n-3 polyunsaturated fatty acids enriched lipid emulsions on nosocomial infections and clinical outcomes in critically ill patients: ICU lipids study Crit Care Med. 2015; 43(1): 31–9. DOI: 10.1097/CCM.0000000000000612
- Pradelli L., Mayer K., Klek S., et al. Omega-3 fatty-acid enriched parenteral nutrition in hospitalized patients: systematic review with meta-analysis and trial sequential analysis. J Parenter Enter Nutr. 2020; 44(1): 44–57. DOI: 10.1002/jpen.1672
- Лейдерман И.Н., Ярошецкий А.И., Кокарев Е.А., Мазурок В.А. Парентеральное питание. Вопросы и ответы. Руководство для врачей. СПб.: Онли-Пресс, 2016. [Leiderman I.N., Yaroshetskiy A.I., Kokarev E.A., Mazurok V.A. Parenteral nutrition. Questions and answers. A guide for doctors. St. Petersburg: Online-Press, 2016. (In Russ)]
- Lau C.S., Chamberlain R.S. Enhanced Recovery after Surgery Programs Improve Patient Outcomes and Recovery: A Meta-analysis. World J Surg. 2017; 41(4): 899–913. DOI: 10.1007/s00268-016-3807-4
- Bu J., Li N., Huang X., et al. Feasibility of Fast-Track Surgery in Elderly Patients with Gastric Cancer. J Gastrointest Surg. 2015; 19(8): 1391–8. DOI: 10.1007/s11605-015-2839-7
- Willcutts K.F., Chung M.C., Erenberg C.L., et al. Early Oral Feeding as Compared With Traditional Timing of Oral Feeding After Upper Gastrointestinal Surgery: A Systematic Review and Meta-analysis. Ann Surg. 2016; 264(1): 54–63. DOI: 10.1097/SLA.0000000000001644
- Shimizu N., Oki E., Tanizawa Y., et al. Effect of early oral feeding on length of hospital stay following gastrectomy for gastric cancer: a Japanese multicenter, randomized controlled trial. Surgery Today. 2018; 48(9): 865–74. DOI: 10.1007/s00595-018-1665-4
- Low D.E., Allum W., De Manzoni G., et al. Guidelines for Perioperative Care in Esophagectomy: Enhanced Recovery After Surgery (ERAS) Society Recommendations. World J Surg. 2019; 43(2): 299–330. DOI: 10.1007/s00268-018-4786-4
- Потапов А.Л., Хороненко В.Э., Гамеева Е.В. и др. Дополнительное пероральное питание: прикладная классификация смесей и ключевые правила применения в онкологии. Вопросы питания. 2020; 89(1): 69–76. DOI: 10.24411/0042-8833-2020-10008 [Potapov A.L., Khoronenko V.E., Gameeva E.V., et al. Oral nutrition supplements: applied classification of formulas and basic rules of their prescribing in oncology. Voprosypitaniia [Problems of Nutrition. 2020; 89(1): 69–76. DOI: 10.24411/0042-8833-2020-10008 (In Russ)]
- West M.A., Wischmeyer P.E., Grocott M.P.W. Prehabilitation and Nutritional Support to Improve Perioperative Outcomes. Curr Anesthesiol Rep. 2017; 7(4): 340–9. DOI: 10.1007/s40140-017-0245-2
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