Optimizing Nutrition Before Surgery

Nutritional status is a major factor in determining the outcomes of surgery. In order to enhance surgical outcomes, preoperative nutrition must be a focus. Today, we break down how to improve nutritional status leading up to surgery to help enhance surgical outcomes. 

What is preoperative nutrition?

Preoperative nutrition covers a wide variety of things, from assessing and correcting nutritional status before surgery, providing immunonutrition, and carbohydrate loading up to two hours before your surgery. There is a lot involved in preoperative nutrition, and understanding each component can significantly enhance your recovery. 

Should I perform a preoperative nutrition assessment?

YES! One of the main ERAS® preoperative principles is pre-admission counseling. This helps you, as the medical professional, ensure your patients are strong and well nourished before their procedure. There is a strong association between poor nutritional status and surgical outcomes. Several studies report that preoperative nutrition to correct poor nutritional status improves outcomes postoperatively.

How can I correct malnutrition?

Appropriate preoperative nutrition can reduce complications and short hospital stays. CF(Protein)® is a plant-based protein drink you can consume in the days and weeks leading up to your surgery to optimize your nutrition. It contains high-quality plant protein, omega three fatty acids, and anti-inflammatory ingredients that will enhance your immune system and optimize your overall health. It is a complete nutrition product to help build muscle and strength for a speedy recovery. Other ways to improve nutritional status can include enteral or parenteral nutrition. 

How does preoperative carbohydrate loading enhance my patient’s recovery?

Surgery induces a catabolic effect on the body. Reducing the fasting period can help reduce this catabolic effect and enhance recovery. Preoperative carbohydrate loading with CF(Preop)® is also an essential component of preoperative nutrition. Prolonged before surgery fasting may cause detrimental effects. Prolonged fasting worsens the catabolic state, increases metabolic stress, hyperglycemia, and insulin resistance.

Furthermore, when the body fasts for a prolonged time, glycogen stores are depleted, leading to protein and muscle breakdown. Postoperative insulin resistance (PIR), a result of the stress response from surgery and further exaggerated with prolonged fasting, is directly related to delayed wound healing, increased morbidity/mortality, and length of stay (LOS). Decreased PIR sets you up for a smoother recovery. Preoperative carbohydrate loading maximizes glycogen stores in the body as an energy source to minimize body tissues’ degeneration and reduce insulin resistance. Changing the metabolic state by shortening preoperative fasting (aka providing CF(Preop)® 2-3 hours before surgery), PIR decreases, protein loss drops, and muscle function will improve. Additionally, preoperative carbohydrate loading increases patients’ comfort and reduces hunger, thirst, and anxiety, leading to surgery, all decreasing stress entering surgery. 

How does preoperative nutrition benefit the medical professional?

Screening patients’ nutritional status, correcting malnutrition and providing preoperative nutrition benefit patients and medical professionals alike. The patient will benefit from a smoother recovery, and the medical professional will help with cost savings, reduced length of stay and postoperative complications, and less readmission. Braga et al. conducted a cost-benefit analysis in 2020 in patients having GI surgery for cancer. They found cost savings secondary to avoidance of complications postoperatively. The study included 305 patients. The groups who received preoperative immunonutrition five days before surgery and the group who received immunonutrition with jejunal feeds consumed 78% of their diagnosis-related group reimbursement rate. In contrast, the group with no supplementation preoperatively consumed over 93% of their diagnosis-related group reimbursement rate. This illustrates the cost savings of providing preoperative nutrition. 

Use CF Nutrition products to optimize your patients’ nutrition before surgery. Explore our website for more information on preoperative nutrition!

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