this guideline reflects the recommendations of the group of specialists of the Brazilian College of Surgeons , the Brazilian Society of Parenteral and Enteral Nutrition and the ACERTO Project for nutritional interventions in the perioperative period of Elective General Surgery .
The prescription of these recommendations can accelerate the postoperative recovery of patients su bmi tted to elective general surgery , with decrease in morbidity , length of stay and rehospitalization , and consequently , of costs
OBJECTIVE to present recommendations based on the ACERTO Project ( Acceleration of Total Post-Operative Recovery ) and supported by evidence related to perioperative nutritional care in General Surgery elective procedures .
Efficacy and Safety of Glutamine-supplemented Parenteral Nutrition in Surgical ICU Patients: An American Multicenter Randomized Controlled Trial
Objective : To determine whether glutamine (GLN)-supplemented parenteral nutrition ( PN ) improves clinical outcomes in surgical intensive care unit ( SICU ) patients . Summary Background Data : GLN requirements may increase with critical illness . GLN-supplemented PN may improve clinical outcomes in SICU patients . Methods : A parallel-group , multicenter , double-blind , r and omized , controlled clinical trial in 150 adults after gastrointestinal , vascular , or cardiac surgery requiring PN and SICU care . Patients were without significant renal or hepatic failure or shock at entry . All received isonitrogenous , isocaloric PN [ 1.5 g/kg/d amino acids ( AAs ) and energy at 1.3 × estimated basal energy expenditure ] . Controls ( n = 75 ) received st and ard GLN-free PN ( STD-PN ) ; the GLN group ( n = 75 ) received PN containing alanyl-GLN dipeptide ( 0.5 g/kg/d ) , proportionally replacing AA in PN ( GLN-PN ) . Enteral nutrition ( EN ) was advanced and PN weaned as indicated . Hospital mortality and infections were primary endpoints . Results : Baseline characteristics , days on study PN and daily macronutrient intakes via PN and EN , were similar between groups . There were 11 hospital deaths ( 14.7 % ) in the GLN-PN group and 13 deaths in the STD-PN group ( 17.3 % ; difference , −2.6 % ; 95 % confidence interval , −14.6 % to 9.3 % ; P = 0.66 ) . The 6-month cumulative mortality was 31.4 % in the GLN-PN group and 29.7 % in the STD-PN group ( P = 0.88 ) . Incident bloodstream infection rate was 9.6 and 8.4 per 1000 hospital days in the GLN-PN and STD-PN groups , respectively ( P = 0.73 ) . Other clinical outcomes and adverse events were similar . Conclusions : PN supplemented with GLN dipeptide was safe , but did not alter clinical outcomes among SICU patients
this guideline reflects the recommendations of the group of specialists of the Brazilian College of Surgeons , the Brazilian Society of Parenteral and Enteral Nutrition and the ACERTO Project for nutritional interventions in the perioperative period of Elective General Surgery .
The prescription of these recommendations can accelerate the postoperative recovery of patients su bmi tted to elective general surgery , with decrease in morbidity , length of stay and rehospitalization , and consequently , of costs
OBJECTIVE to present recommendations based on the ACERTO Project ( Acceleration of Total Post-Operative Recovery ) and supported by evidence related to perioperative nutritional care in General Surgery elective procedures .