The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .
Randomised trial of glutamine-enriched enteral nutrition on infectious morbidity in patients with multiple trauma
BACKGROUND Infections are an important cause of morbidity and mortality in patients with multiple trauma . Studies in both animals and human beings have suggested that glutamine-enriched nutrition decreases the number of infections . METHODS Patients with multiple trauma with an expected survival of more than 48 h , and who had an Injury Severity Score of 20 or more , were r and omly allocated glutamine supplemented enteral nutrition or a balanced , isonitrogenous , isocaloric enteral-feeding regimen along with usual care . Each patient was assessed every 8 h for infection , the primary endpoint . Data were analysed both per protocol , which included enteral feeding for at least 5 days , and by intention to treat . FINDINGS 72 patients were enrolled and 60 received enteral feeding ( 29 glutamine-supplemented ) for at least 5 days . Five ( 17 % ) of 29 patients in the glutamine-supplemented group had pneumonia compared with 14 ( 45 % ) of 31 patients in the control group ( p<0.02 ) . Bacteraemia occurred in two ( 7 % ) patients in glutamine group and 13 ( 42 % ) in the control group ( p<0.005 ) . One patient in the glutamine group had sepsis compared with eight ( 26 % ) patients in the control group ( p<0.02 ) . INTERPRETATION There was a low frequency of pneumonia , sepsis , and bacteraemia in patients with multiple trauma who received glutamine-supplemented enteral nutrition . Larger studies are needed to investigate whether glutamine-supplemented enteral nutrition reduces mortality
The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .