Wischmeyer PE, Carli F, Evans DC, Guilbert S, Kozar R, Pryor A, Thiele RH, Everett S, Grocott M, Gan TJ, Shaw AD, Thacker JKM, Miller TE, Hedrick TL, McEvoy MD, Mythen MG, Bergamaschi R, Gupta R, Holubar SD, Senagore AJ, Abola RE, Bennett-Guerrero E, Kent ML, Feldman LS, Fiore JF Jr, Perioperative Quality Initiative (POQI) 2 Workgroup., et al.
Anesthesia and analgesia. Date of publication 2018 Jun 1;volume 126(6):1883-1895.
1. Anesth Analg. 2018 Jun;126(6):1883-1895. doi: 10.1213/ANE.0000000000002743.
American Society for Enhanced Recovery and Perioperative Quality Initiative Joint
Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced
Recovery Pathway.
Wischmeyer PE(1), Carli F(2), Evans DC(3), Guilbert S(4), Kozar R(5), Pryor A(6),
Thiele RH(7), Everett S(8), Grocott M(9)(10)(11)(12), Gan TJ(13), Shaw
AD(14)(15), Thacker JKM(16), Miller TE(17), Hedrick TL, McEvoy MD, Mythen MG,
Bergamaschi R, Gupta R, Holubar SD, Senagore AJ, Abola RE, Bennett-Guerrero E,
Kent ML, Feldman LS, Fiore JF Jr; Perioperative Quality Initiative (POQI) 2
Workgroup.
Author information:
(1)From the Department of Anesthesiology, Duke University School of Medicine,
Durham, North Carolina.
(2)McGill University, Montreal, Québec, Canada.
(3)Department of Surgery, Division of Trauma, Critical Care, and Burn, Ohio State
University, Columbus, Ohio.
(4)Duke University Hospital, Durham, North Carolina.
(5)University of Maryland School of Medicine, Baltimore, Maryland.
(6)Department of Surgery, Stony Brook Medicine, Stony Brook, New York.
(7)Departments of Anesthesiology and Biomedical Engineering, Divisions of
Cardiac, Thoracic, and Critical Care Anesthesiology, University of Virginia
School of Medicine, Charlottesville, Virginia.
(8)Nutrition Division, Department of Family, Population, Preventive Medicine,
Stony Brook Medicine, Stony Brook, New York.
(9)Respiratory and Critical Care Research Area, National Institute of Health
Research Biomedical Research Centre, University Hospital Southampton,
Southampton, United Kingdom.
(10)Southampton National Health Service Foundation Trust, Integrative Physiology
and Critical Illness Group, Southampton, United Kingdom.
(11)Clinical and Experimental Sciences, Faculty of Medicine, University of
Southampton, Southampton, United Kingdom.
(12)Morpheus Collaboration, Department of Anesthesiology, Duke University School
of Medicine, Durham, North Carolina.
(13)Department of Anesthesiology, Stony Brook University School of Medicine,
Stony Brook, New York.
(14)Vanderbilt University School of Medicine, Nashville, Tennessee.
(15)Department of Anesthesiology, Vanderbilt University Medical Center,
Nashville, Tennessee.
(16)Department of Surgery, Division of Advanced Oncologic and Gastrointestinal
Surgery.
(17)Division of General, Vascular and Transplant Anesthesia, Duke University
Medical Center, Durham, North Carolina.
Erratum in
Anesth Analg. 2018 Nov;127(5):e95.
Comment in
Anesth Analg. 2018 Jun;126(6):1803-1804.
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.
DOI: 10.1213/ANE.0000000000002743
PMID: 29369092 [Indexed for MEDLINE]
