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Clinical evidence for pharmaconutrition in major elective surgery.

Publication ,  Journal Article
Braga, M; Wischmeyer, PE; Drover, J; Heyland, DK
Published in: JPEN J Parenter Enteral Nutr
September 2013

In recent years, standard nutrition preparations have been modified by adding specific nutrients, such as arginine, ω-3 fatty acids, glutamine, and others, which have been shown to upregulate host immune response, modulate inflammatory response, and improve protein synthesis after surgery. Most randomized trials and several meta-analyses have shown that perioperative administration of enteral arginine, ω-3 fatty acids, and nucleotides (immunonutrition) reduced infection rate and length of hospital stay in patients with upper and lower gastrointestinal (GI) cancer. The most pronounced benefits of immunonutrition were found in subgroups of high-risk and malnourished patients. Promising but not conclusive results have been found in non-GI surgery, especially in head and neck surgery and in cardiac surgery, but larger trials are required before recommending immunonutrition as a routine practice. Conflicting results on the real benefit of parenteral glutamine supplementation in patients undergoing elective major surgery have been published. In conclusion, enteral diets supplemented with specific nutrients significantly improved short-term outcome in patients with cancer undergoing elective GI surgery. Future research should investigate a molecular signaling pathway and identify specific mechanisms of action of immune-enhancing substrates.

Duke Scholars

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Published In

JPEN J Parenter Enteral Nutr

DOI

EISSN

1941-2444

Publication Date

September 2013

Volume

37

Issue

5 Suppl

Start / End Page

66S / 72S

Location

United States

Related Subject Headings

  • Randomized Controlled Trials as Topic
  • Postoperative Complications
  • Perioperative Care
  • Nutritional Support
  • Nutritional Status
  • Nutrition & Dietetics
  • Multicenter Studies as Topic
  • Length of Stay
  • Humans
  • Glutamine
 

Citation

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Braga, M., Wischmeyer, P. E., Drover, J., & Heyland, D. K. (2013). Clinical evidence for pharmaconutrition in major elective surgery. JPEN J Parenter Enteral Nutr, 37(5 Suppl), 66S-72S. https://doi.org/10.1177/0148607113494406
Braga, Marco, Paul E. Wischmeyer, John Drover, and Daren K. Heyland. “Clinical evidence for pharmaconutrition in major elective surgery.JPEN J Parenter Enteral Nutr 37, no. 5 Suppl (September 2013): 66S-72S. https://doi.org/10.1177/0148607113494406.
Braga M, Wischmeyer PE, Drover J, Heyland DK. Clinical evidence for pharmaconutrition in major elective surgery. JPEN J Parenter Enteral Nutr. 2013 Sep;37(5 Suppl):66S-72S.
Braga, Marco, et al. “Clinical evidence for pharmaconutrition in major elective surgery.JPEN J Parenter Enteral Nutr, vol. 37, no. 5 Suppl, Sept. 2013, pp. 66S-72S. Pubmed, doi:10.1177/0148607113494406.
Braga M, Wischmeyer PE, Drover J, Heyland DK. Clinical evidence for pharmaconutrition in major elective surgery. JPEN J Parenter Enteral Nutr. 2013 Sep;37(5 Suppl):66S-72S.
Journal cover image

Published In

JPEN J Parenter Enteral Nutr

DOI

EISSN

1941-2444

Publication Date

September 2013

Volume

37

Issue

5 Suppl

Start / End Page

66S / 72S

Location

United States

Related Subject Headings

  • Randomized Controlled Trials as Topic
  • Postoperative Complications
  • Perioperative Care
  • Nutritional Support
  • Nutritional Status
  • Nutrition & Dietetics
  • Multicenter Studies as Topic
  • Length of Stay
  • Humans
  • Glutamine