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Consenso multidisciplinar sobre la terapia nutricional y metabólica en los programas de recuperación intensificada en cirugía abdominal: Proyecto NutRICA

Authors :
Carlos Miguel Peteiro Miranda
Ana Zugasti Murillo
Francisco Botella Romero
Juan José López Gómez
Julia Álvarez Hernández
M Julia Ocón Bretón
M José Tapia Guerrero
María Dolores Ballesteros Pomar
José Manuel Ramírez Rodriguez
Emilia Cancer Minchot
Miguel Ángel Martínez Olmos
Luis Miguel Luengo Pérez
Katherine García Malpartida
Irene Bretón Lesmes
Source :
Endocrinología, Diabetes y Nutrición. 69:98-111
Publication Year :
2022
Publisher :
Elsevier BV, 2022.

Abstract

Background: The Enhanced Recovery After Surgery (ERAS) care pathways include evidence-based items designed to accelerate recovery after surgery. Interdisciplinarity is one of the key points of ERAS programs. Objective: To prepare a consensus document among the members of the Nutrition Area of the Spanish Society of Endocrinology and Nutrition (SEEN) and the Spanish Group for Multimodal Rehabilitation (GERM), in which the goal is to homogenize the nutritional and metabolic management of patients included in an ERAS program. Methods: 69 specialists in Endocrinology and Nutrition and 85 members of the GERM participated in the project. After a literature review, 79 statements were proposed, divided into 5 sections: 17 of general characteristics, 28 referring to the preoperative period, 4 to the intraoperative, 13 to the perioperative and 17 to the postoperative period. The degree of consensus was determined through a Delphi process of 2 circulations that was ratified by a consistency analysis. Results: Overall, in 61 of the 79 statements there was a consistent agreement, with the degree of consensus being greater among members of the SEEN (64/79) than members of the GERM (59/79). Within the 18 statements where a consistent agreement was not reached, we should highlight some important nutritional strategies such as muscle mass assessment, the start of early oral feeding or pharmaconutrition. Conclusion: Consensus was reached on the vast majority of the nutritional measures and care included in ERAS programs. Due to the lack of agreement on certain key points, it is necessary to continue working closely with both societies to improve the recovery of the surgical patients.

Details

ISSN :
25300164
Volume :
69
Database :
OpenAIRE
Journal :
Endocrinología, Diabetes y Nutrición
Accession number :
edsair.doi...........08e85afbb1b231f4a04f57aff8dbe7f0
Full Text :
https://doi.org/10.1016/j.endinu.2021.02.005