Enteral vs parenteral nutrition
2003; Elsevier BV; Volume: 22; Linguagem: Inglês
10.1016/s0261-5614(03)00156-0
ISSN1532-1983
Autores Tópico(s)Esophageal and GI Pathology
ResumoBetween 1974 and 1976 Bristrian and co-workers published two papers showing a high incidence of malnutrition in patients admitted to medical and surgical wards ( 1. Bistrian B R, Blackburn G L, Hallowell E, Heddie R. Protein status of general surgical patients. J Am Med Assoc 1974; 230: 858–860 Google Scholar , 2. Bistrian B R, Blackburn G L, Vitale J, Cochran D, Naylor J. Prevalence of malnutrition in general medical patients. J Am Med Assoc 1976; 253: 1567–1570 Google Scholar ). Nearly 20 years later McWhirter and Pennington showed that up to 40% of patients admitted to a variety of medical and surgical wards were malnourished ( 3. McWhirter J P, Pennington C R. Incidence and recognition of malnutrition in hospital. Br Med J 1994; 308: 945–948 Google Scholar ). Malnutrition associated with disease (disease related malnutrition) does not commence in the hospital setting but starts in the community ( 4. Edington J, Kon P, Martyn C N. Prevalence of malnutrition in general practice. Clin Nutr 1994; 15: 60–63 Google Scholar ) and is established in many by the time they reached the hospital setting ( 4. Edington J, Kon P, Martyn C N. Prevalence of malnutrition in general practice. Clin Nutr 1994; 15: 60–63 Google Scholar , 5. Martyn C N, Winter P D, Coles S J, Edington J. The effect of nutritional status on use of health care resources by patients with chronic disease living in the community. Clin Nutr 1998; 17: 119–123 Google Scholar ). Patients with disease-related malnutrition have been shown to be higher consumers of healthcare resources with the attendant economic implications in both the community and the hospital setting ( 5. Martyn C N, Winter P D, Coles S J, Edington J. The effect of nutritional status on use of health care resources by patients with chronic disease living in the community. Clin Nutr 1998; 17: 119–123 Google Scholar , 6. Reilly J J, Hull S, Albert N, Waller A, Bringardener S. Economic impact of malnutrition: a model system for hospitalized patients. J Parenter Enteral Nutr 1988; 12(4): 371–376 Google Scholar , 7. Robinson G, Goldstein M, Levine G M. Impact of nutritional status on DRG length of stay. J Parenter Enteral Nutr 1987; 11: 49–51 Google Scholar ). More than 60 years ago an association between pre-operative weight loss and incidence of post operative complications and mortality was documented ( 8. Studley H O. Percentage of weight loss, abasic indicator of surgical risk in patients with chronic peptic ulcer. JAMA 1936; 106: 458–460 Google Scholar ). Since their numerous publications ( 6. Reilly J J, Hull S, Albert N, Waller A, Bringardener S. Economic impact of malnutrition: a model system for hospitalized patients. J Parenter Enteral Nutr 1988; 12(4): 371–376 Google Scholar , 9. Brown R, Bancewick J, Hamid J, Patel N J, Ward C A. Failure of delayed hypersensitivity skin testing to predict postoperative sepsis and mortality. Br Med J 1982; 284: 851–853 Google Scholar , 10. Jensen J E, Jensen T G, Smith T K, Johnston D A, Dudrick S J. Nutrition in orthopaedic surgery. J Bone Joint Surg 1982; 64A: 1263–1272 Google Scholar , 11. Warnold I, Lundholm K. Clinial significance of preoperative nutritional status in 215 noncancer patients. Ann Surg 1984; 201: 299–305 Google Scholar , 12. Haydock D A, Hill G L. Impaired wound healing in surgical patients with varying degrees of malnutrition. J Parent Enter Nutr 1986; 10: 550–554 Google Scholar , 13. Windsor J A, Hill G L. Grip strength: a measure of the proportion of protein loss in surgical patients. Br J Surg 1988; 75: 880–882 Google Scholar , 14. Windsor J A, Hill G L. Weight loss with physiological impairment. A basic indicator of surgical risk. Ann Surg 1988; 205: 290–296 Google Scholar , 15. Dempsey D T, Mullen J L, Buzby G P. The link between nutritional status and clinical outcome: can nutritional intervention modify it? Am J Clin Nutr 1988; 47: 352–356 Google Scholar , 16. Meguid M M, Campos A C L, Meguid V, Debonis D, Terz J J. IONIP, a criterion of surgical outcome and patient selection for perioperative nutritional support. Br J Clin Pract 1988; (Suppl 63): 8–14 Google Scholar , 17. Bashir Y, Graham T R, Torrance A, Gibson G J, Corns P A. Nutritional state of patients with lung cancer undergoing thoracotomy. Thorax 1990; 45: 183–186 Google Scholar , 18. Senapati A, Slavin B M, Thompson R P H. Zinc depletion and complications of surgery. Clin Nutr 1990; 9: 341–346 Google Scholar , 19. von Meyenfeldt M F, Meijerink W J H J, Rouflart M M J, Builmaassen M T H J, Soeters P B. Perioperative nutritional support: a randomised clinical trial. Clin Nutr 1992; 11: 180–186 Google Scholar , 20. Madden A M, McCormick P A, Davidson B, Rolles K, Burroughs A K, Morgan M Y. Nutritional status and survival of patients after liver transplant. Nutrition 1994; 10: 504 Google Scholar , 21. Sagar P, MacFie J. Effect ofpreoperative nutritional status on the outcome of cardiac valve replacement. Nutrition 1994; 10: 490 Google Scholar , 22. Dannhauser A, van Zyl J M, Nel C J C. Preoperative nutritional status and prognostic nutritional index in patients with benign disease undergoing abdominal operations. J Am Coll Nutr 1995;14: 80–90 Google Scholar , 23. Gianotti L, Braga M, Radaelli G, Mariani L, Vignali A, Di Carlo V. Lack of improvement of prognostic weight loss when combined with other parameters. Nutrition 1995; 11: 12–16 Google Scholar , 24. Bastow M D, Rawlings J, Allison S P. Benefits of supplementary tube feeding after fractured neck of femur: a randomised controlled trial. Br Med J 1983; 287: 1589–1592 Google Scholar , 25. Brown K M, Seabrook N A. Nutritional influences on recovery and length of hospital stay in elderly women following femoral fracture. Proc Nutr Soc 1992; 51: 132A Google Scholar , 26. Delmi M, Rapin C H, Bengoa J M, Delmas P D, Vasey H, Bonjour J P. Dietary supplementation in elderly patients with fractured neck of femur. Lancet 1990; 335: 1013–1016 Google Scholar ) have provided evidence to support the concept of malnutrition has an adverse effect on clinical outcome. Importantly, McWhirter and Pennington showed that if malnutrition is left unrecognised, further weight loss occurs whereas if the diagnosis of diseased malnutrition is recognised and acted upon the patients gain weight ( 3. McWhirter J P, Pennington C R. Incidence and recognition of malnutrition in hospital. Br Med J 1994; 308: 945–948 Google Scholar ).
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