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American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway.

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Date
2018-01-23
Authors
Wischmeyer, Paul E
Carli, Franco
Evans, David C
Guilbert, Sarah
Kozar, Rosemary
Pryor, Aurora
Thiele, Robert H
Everett, Sotiria
Grocott, Mike
Gan, Tong J
Shaw, Andrew D
Thacker, Julie KM
Miller, Timothy E
Hedrick, Traci L
McEvoy, Matthew D
Mythen, Michael G
Bergamaschi, Roberto
Gupta, Ruchir
Holubar, Stefan D
Senagore, Anthony J
Abola, Ramon E
Bennett-Guerrero, Elliott
Kent, Michael L
Feldman, Liane S
Fiore, Julio F
Perioperative Quality Initiative (POQI) 2 Workgroup
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Abstract
Perioperative malnutrition has proven to be challenging to define, diagnose, and treat. Despite these challenges, it is well known that suboptimal nutritional status is a strong independent predictor of poor postoperative outcomes. Although perioperative caregivers consistently express recognition of the importance of nutrition screening and optimization in the perioperative period, implementation of evidence-based perioperative nutrition guidelines and pathways in the United States has been quite limited and needs to be addressed in surgery-focused recommendations. The second Perioperative Quality Initiative brought together a group of international experts with the objective of providing consensus recommendations on this important topic with the goal of (1) developing guidelines for screening of nutritional status to identify patients at risk for adverse outcomes due to malnutrition; (2) address optimal methods of providing nutritional support and optimizing nutrition status preoperatively; and (3) identifying when and how to optimize nutrition delivery in the postoperative period. Discussion led to strong recommendations for implementation of routine preoperative nutrition screening to identify patients in need of preoperative nutrition optimization. Postoperatively, nutrition delivery should be restarted immediately after surgery. The key role of oral nutrition supplements, enteral nutrition, and parenteral nutrition (implemented in that order) in most perioperative patients was advocated for with protein delivery being more important than total calorie delivery. Finally, the role of often-inadequate nutrition intake in the posthospital setting was discussed, and the role of postdischarge oral nutrition supplements was emphasized.
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Journal article
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https://hdl.handle.net/10161/16036
Published Version (Please cite this version)
10.1213/ANE.0000000000002743
Publication Info
Wischmeyer, Paul E; Carli, Franco; Evans, David C; Guilbert, Sarah; Kozar, Rosemary; Pryor, Aurora; ... Perioperative Quality Initiative (POQI) 2 Workgroup (2018). American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway. Anesth Analg. 10.1213/ANE.0000000000002743. Retrieved from https://hdl.handle.net/10161/16036.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Miller

Timothy Ellis Miller

Professor of Anesthesiology
Clinical and research interests are Enhanced Recovery and Perioperative Medicine; with particular interests in fluid management, and perioperative optimization of the high-risk non-cardiac surgery patient.
Thacker

Julie K. Marosky Thacker

Associate Professor of Surgery
Wischmeyer

Paul Edmund Wischmeyer

Professor of Anesthesiology
Paul Wischmeyer M.D., EDIC, FASPEN, FCCM is a critical care, perioperative, and nutrition physician-researcher who specializes in enhancing preparation and recovery from surgery, critical care and COVID-19. He serves as a Tenured Professor of Anesthesiology and Surgery at Duke. He also serves as the Associate Vice Chair for Clinical Research in the Dept. of Anesthesiology and Director of the TPN/Nutrition Team at Duke. Dr. Wischmeyer earned his medical degree with honors at T
Alphabetical list of authors with Scholars@Duke profiles.
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