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Cited by 350Enhanced Recovery After SurgeryClinical Nutrition and GastroenterologyHyperglycemia and glycemic control in critically ill and hospitalized patients

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Promoting Perioperative Metabolic and Nutritional Care

Gillis, Chelsia, Carli, Francesco·2015·Anesthesiology
DOI 10.1097/aln.0000000000000795
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Abstract

AbstractAbstract: Surgery represents a major stressor that disrupts homeostasis and can lead to loss of body cell mass. Integrated, multidisciplinary medical strategies, including enhanced recovery programs and perioperative nutrition support, can mitigate the surgically induced metabolic response, promoting optimal patient recovery following major surgery. Clinical therapies should identify those who are poorly nourished before surgery and aim to attenuate catabolism while preserving the processes that promote recovery and immunoprotection after surgery. This review will address the impact of surgery on intermediary metabolism and describe the clinical consequences that ensue. It will also focus on the role of perioperative nutrition, including preoperative nutrition risk, carbohydrate loading, and early initiation of oral feeding (centered on macronutrients) in modulating surgical stress, as well as highlight the contribution of the anesthesiologist to nutritional care. Emerging therapeutic concepts such as preoperative glycemic control and prehabilitation will be discussed. This article is a narrative review that focuses on the role of perioperative nutrition in modulating the surgical stress response, as well as the contribution of the anesthesiologist to nutritional care. Preoperative nutrition risk, carbohydrate loading, early initiation of oral feeding, anesthetic strategies to facilitate nutritional gains, preoperative glycemic control, and prehabilitation will be addressed.

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Metadata

Authors
Gillis, C., & Carli, F.
Affiliations
McGill University Health Centre (CA)
Corresponding author
Carli, Francesco
ORCID
Venue
Anesthesiology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-12
Volume
123
Issue
6
Pages
1455-1472
ISSN
0003-3022 (ISSN-L)
DOI
10.1097/aln.0000000000000795
OpenAlex
W1905230518
Cited by
350
References
0
Citations by year
2026: 44 · 2025: 38 · 2024: 56 · 2023: 51 · 2022: 44 · 2021: 31 · 2020: 34 · 2019: 18 · 2018: 15 · 2017: 11 · 2016: 7
FWCI
2.11
Type
journal article
Language
en
Open access
closed
Locations
  • Anesthesiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
McGill University Health Centre
Topics
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
Keywords
perioperative nutrition, enhanced recovery after surgery, surgical stress response, intermediary metabolism, catabolism, carbohydrate loading, early oral feeding, prehabilitation, preoperative glycemic control, immunoprotection, malnutrition
MeSH terms
Humans, Nutritional Status, Postoperative Complications, Preoperative Care, Surgical Procedures, Operative, Nutritional Support, Perioperative Care

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