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Current Concepts in Nutritional Assessment
David E. Carney, MD;
Michael M. Meguid, MD, PhD
Arch Surg. 2002;137:42-45.
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The management of surgical illness requires appropriate metabolic and physiologic adjustment to preserve tissue and organ function. A patient's baseline nutritional status along with optimal nutritional support will provide the substrate to meet the increase in metabolic demand. Adequate response to metabolic demands allows the host to limit catabolism, promote wound healing, and muster a defense against infection. Delivery of appropriate metabolic support begins with adequate assessment of nutritional status.
It is important to recognize and treat malnutrition as a problem often equal to the primary diagnosis. As early as the 1930s it was noted that postoperative complications and deaths were more likely if patients had disease-related malnutrition.1-2 The known physiologic consequences of malnutrition include impaired respiratory muscle function with its attendant reduction in vital capacity and minute ventilation, reduced cardiac contractility, increased thrombogenicity, and impaired renal function. The manifestations of . . . [Full Text of this Article]
From the Surgical Metabolism and Nutrition Laboratory, Department of Surgery, Upstate Medical University, Syracuse, NY.
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