Peri-op Care: Nutrition

Question 1

What are the average daily kilocalorie requirements of a patient?

Answer 1

~1800 kcal/day

Question 2

What are the consequences of starvation prior to surgery?

Answer 2

Impaired wound healing, decreased immunity

Stomach is empty = lower risk of aspiration for the pt to chock on

Question 3

What additional demands does surgery place on the nutritional status of the body?

Answer 3

Increases requirements by 20-100%

Lipids become major fuel - catabolic state

Question 4

What is the difference between enteral and parenteral feeding? When is each use?

Answer 4

Enteral = feed delivered into GI tract, always preferred option

Parenteral = feed delivered intravenously, e.g. when GI tract not intact or is not functioning (ileus, fistula, massive small bowel resection)

Question 5

When is nasogastric feeding used?

Answer 5

Swallowing difficulties, anorexia, delayed oral feeding after op.

Question 6

When is nasojejunal feeding used?

Answer 6

Pts requiring post-pyloric feeding, e.g. acute pancreatitis, or pts with recurrent aspiration e.g. severe GORD

Question 7

When is gastrostomy (surgical or PEG) used?

Answer 7

Stroke or oesophagus blocked/dysfunctional

Question 8

When is jejunostomy feeding used?

Answer 8

Patients at risk of gastric and pulmonary aspiration, patients requiring long term enteric feeding

Question 9

What are the complications associated with parenteral feeding?

Answer 9

Catheter related sepsis

Thrombosis

Hyper/hypoglycaemia

Infection

Liver failure

Micronutrient def