School of Allied Health Sciences, Griffith University, Gold Coast Campus, QLD, Australia.
School of Nursing and Midwifery, Griffith University, Gold Coast Campus, QLD, Australia.
Nutr Clin Pract. 2019 Jun;34(3):371-380. doi: 10.1002/ncp.10103. Epub 2018 Jun 7.
Evidence-based guidelines (EBG) recommend recommencing oral feeding (liquids and solids) ≤24 hours after surgery. The aims of this study were to determine time to first diet (any) and solid-diet prescriptions, delivery, and intakes among adult, non-critically ill, postoperative patients.
This prospective cross-sectional study included 100 postsurgical patients. Demographic and perioperative dietary-related data were collected from patients' medical records or via direct observation. Dietary intakes were observed for the duration patients were enrolled in the study (from end of surgery to discharge). The amount of energy (kcal) and protein (g) consumed per patient per day was analyzed and considered adequate if it met ≥75% of a patient's estimated requirements.
89 and 52 patients consumed their first intake and first solid intake ≤24 hours after surgery, respectively. For their first intake, 53% of patients had clear or free liquids. Median times to first diet prescription (range: 1.3-5.7 hours), delivery (range: 2.1-12.5 hours), and intake (range: 2.2-13.9 hours) were ≤24 hours after surgery for all patient groups. Time to first solid-diet prescription (range: 1.3-77.8 hours), delivery (range: 2.1-78.0 hours) and intake (range: 2.2-78.2 hours) varied considerably. Urologic and gastrointestinal patients experienced the greatest delays to first solid-diet prescription and first solid intake. Only 26 patients met both their energy and protein requirements for ≥1 day during their stay.
While practice appears consistent with EBG recommendations for commencing nutrition (any type) after surgery, the reintroduction of adequate diet requires improvement.
循证指南(EBG)建议手术后≤24 小时恢复口服喂养(液体和固体)。本研究的目的是确定成人非危重症术后患者首次进食(任何类型)和固体饮食处方、交付和摄入量的时间。
这是一项前瞻性的横断面研究,纳入了 100 名术后患者。从患者的病历或直接观察中收集人口统计学和围手术期饮食相关数据。在患者入组研究期间(从手术结束到出院)观察饮食摄入量。分析每位患者每天消耗的能量(千卡)和蛋白质(克)量,如果满足患者估计需求的≥75%,则认为摄入量充足。
分别有 89 名和 52 名患者在手术后≤24 小时内首次摄入液体和固体。对于他们的第一次摄入,53%的患者有清亮或自由流动的液体。所有患者群体首次饮食处方(范围:1.3-5.7 小时)、交付(范围:2.1-12.5 小时)和摄入(范围:2.2-13.9 小时)的中位数时间都在手术后≤24 小时内。首次固体饮食处方(范围:1.3-77.8 小时)、交付(范围:2.1-78.0 小时)和摄入(范围:2.2-78.2 小时)的时间差异很大。泌尿科和胃肠道患者首次固体饮食处方和首次固体摄入的延迟时间最长。只有 26 名患者在住院期间≥1 天满足了他们的能量和蛋白质需求。
尽管手术后开始营养(任何类型)的实践似乎与 EBG 建议一致,但恢复足够饮食的需求仍需改进。