Nutrition dans la période postopératoire (dont urgence)

Policies which tend to reduce surgical stress and therefore decrease catabolism and to improve anabolism could allow patients to recover more quickly and efficiently even after major surgery. In most instances, interruption of nutritional intake is not necessary after surgery. Oral intake can be started as soon as possible within the first 24 hours unless surgical contra-indication. Oral intake should be adjusted according to patient's tolerance. In patients without overt under-nutrition, postoperative nutritional support for periods of less than 7 days is not indicated. However, nutritional support is recommended when postoperative food intakes reach less than 60% of daily needs for 7 days. Moreover, early nutritional support should probably be administered if expected postoperative food intake will be less than 60% of daily needs for more than 7 days. In malnourished patients, nutritional support (using enteral rather than parenteral route) is strongly recommended within the first postoperative 24 hours regardless of preoperative nutritional support.