Thoracic surgery and underfeeding scientific evidences, diagnosis and treatment
Kohut, B.; Christodoulou, M.; Soguel, L.; Roulet, M.; Berger, M.M.
Revue Medicale Suisse 1(45): 2940-2944
2005
ISSN/ISBN: 1660-9379 PMID: 16425952 Document Number: 585431
Underfeeding causes a significant increase of postoperative complications, particularly respiratory and infectious complications. Thoracic surgery is frequently required in patients suffering wasting diseases (cancer, COPD, cystic fibrosis), which increase the risk of malnutrition. The most important risk factors are preoperative hypoalbuminemia and BMI < 20. The deleterious effects of underfeeding may be corrected by a preoperative nutritional support for 7 to 15 days using oral supplements or enteral feeding: respiratory muscle strength is improved, immunity is restored, and overall complications are reduced. Therefore preoperative diagnosis of underfeeding is of utmost importance. In case of emergency surgery, the nutritional assessment on admission enables the introduction of early postoperative artificial feeding.