Summary of "Nutrition in surgical patients : Dr.Biju Poattakat"

Summary of "Nutrition in Surgical Patients" by Dr. Biju Poattakat

Main Ideas and Concepts:

Malnutrition as a Disease: Malnutrition is not merely a deficiency but a disease that can significantly impact surgical outcomes. It has specific diagnostic criteria and management tools.
Burden of Malnutrition: A survey revealed a high incidence of Malnutrition among surgical patients in India, with unintended weight loss being a key concern. This is exacerbated by the hospital environment, which can worsen a patient's nutritional status.
Nutritional Assessment:
- Malnutrition should be assessed as a spectrum: mild, moderate, and severe.
- Various tools and methods exist for assessing Malnutrition, including anthropometry, biochemical tests, and dietary history.
- Patients should be considered malnourished unless proven otherwise.
Importance of Gut Integrity: Maintaining gut integrity is crucial for recovery. Feeding the gut is essential for nutrient absorption and overall health.
Principles of Nutritional Management:
- Create an anabolic environment to counteract catabolism.
- Nutritionally unfit patients should not undergo surgery until their nutritional status is improved.
- The importance of Medical Nutrition Therapy (MNT) is emphasized, treating nutrition as a medical intervention.
Methods of Nutritional Support:
- Enteral Nutrition is preferred when possible, as it supports gut health.
- Parenteral Nutrition is an alternative when enteral feeding is not feasible.
- The timing and method of nutrition delivery (e.g., continuous vs. bolus feeding) should be tailored to individual patient needs.
Prehabilitation: Emphasizes the importance of preparing patients nutritionally before surgery to improve recovery outcomes.
Prescription Delivery Mismatch: A common issue in hospitals where prescribed nutritional support is not delivered effectively, highlighting the need for better communication among healthcare teams.

Methodology/Instructions:

Assessing Malnutrition:
- Use a combination of clinical assessment, dietary history, and anthropometric measurements.
- Consider using patient-friendly tools for self-assessment when applicable.
Implementing Medical Nutrition Therapy:
- Evaluate the patient's nutritional needs and create a tailored plan.
- Start with Enteral Nutrition whenever possible, transitioning to Parenteral Nutrition only if necessary.
Monitoring and Adjusting Nutrition Plans:
- Regularly assess the patient’s nutritional status and adjust feeding plans accordingly.
- Be vigilant about the risks of aspiration and metabolic complications, particularly in critically ill patients.
Team Collaboration: Foster communication between surgeons, dietitians, and nursing staff to ensure that nutritional prescriptions are delivered effectively and that all team members understand the importance of nutrition in patient recovery.

Speakers:

Dr. Biju Poattakat: Head of the Department of Surgical Gastroenterology, with extensive experience in nutrition, HPB surgery, and liver transplantation.
Lekha Sridharan: Pediatric dietitian and deputy general manager at Apollo Children's Hospital, with expertise in nutritional assessment.
Radha Krishna: Moderated the session and contributed to discussions.

This summary encapsulates the key points from Dr. Poattakat's presentation on the critical role of Nutrition in Surgical Patients and the collaborative efforts required to manage it effectively.