Perioperative Nutrition in Pediatric Surgical Patients

Introduction: Perioperative nutritional care for neonates, infants and younger children differ greatly from those seen in older children and adults. Nutritional care is essential for accelerated growth and development along with homeostasis and postoperative healing of pediatric surgical patients. Depletion of body stores decreased immunocompetence and increased mortality and morbidity is frequently associated with hyper metabolic state. Abdominal surgery is the most stressful factor leading to the reorganization of metabolic processes, redox homeostasis and immune changes. About 18% to 40% of pediatric surgical patients have malnutrition. Patients at risk for malnutrition are surgical patients, patients with large open wounds (concomitant loss of protein and increased metabolic needs), extensive burns, blunt trauma and sepsis.2 Individualized, adequate nutritional support in the peri-operative period decreases morbidity and mortality. Over past few decades mortality associated with surgery in children has rapidly declined. Refined respiratory care, antibiotics and improved nutrition with a greater knowledge of the needs of the surgical patients have together ameliorated the chances for surgical neonates and infants. 4