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Crit Care. 2017 Jun 5;21(1):131. doi: 10.1186/s13054-017-1690-5.

Role of nutrition support in adult cardiac surgery: a consensus statement from an International Multidisciplinary Expert Group on Nutrition in Cardiac Surgery.

Author information

1
Department of Intensive Care Medicine, University Hospital of the RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany. christian.stoppe@gmail.com.
2
Department of Thoracic, Cardiac and Vascular Surgery, University Hospital, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany. agoetzenich@ukaachen.de.
3
Cardiac Surgical Intensive Care, Johns Hopkins Hospital Baltimore, Blalock 618, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
4
Department of Anesthesia, Royal Victoria Hospital, McGill University Health Centre, Montreal, Canada.
5
Department of Microbiology and Immunology, McGill University Health Centre, Montreal, Canada.
6
Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
7
Division of Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
8
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
9
Department of Surgery, Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, MA, USA.
10
Division of Cardiac Anesthesiology and Critical Care Medicine, University of Ottawa Heart Institute, Ruskin Street H2410, Ottawa, ON, K1Y 4W7, Canada.
11
Department of Medicine, Aristotle University of Thessaloniki, University Campus, Thessaloniki, 54124, Greece.
12
Departments of Anesthesia & Perioperative Medicine and Epidemiology & Biostatistics, University of Western Ontario, London, Canada.
13
Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
14
Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, USA.
15
Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus 12, 24105, Kiel, Germany.
16
Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne, Germany.
17
Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
18
Department of Anesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russia.
19
Department of Anesthesiology and Intensive Care Medicine, National Pirogov Surgical Medical Center, Moscow, Russia.
20
Department of Intensive Care Medicine, University Hospital of the RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
21
Department of Thoracic, Cardiac and Vascular Surgery, University Hospital, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
22
Department of Critical Care Medicine, Queen's University and Clinical Evaluation Research Unit, Angada 4, Kingston General Hospital, Kingston, ON, K7L 2V7, Canada.

Abstract

Nutrition support is a necessary therapy for critically ill cardiac surgery patients. However, conclusive evidence for this population, consisting of well-conducted clinical trials is lacking. To clarify optimal strategies to improve outcomes, an international multidisciplinary group of 25 experts from different clinical specialties from Germany, Canada, Greece, USA and Russia discussed potential approaches to identify patients who may benefit from nutrition support, when best to initiate nutrition support, and the potential use of pharmaco-nutrition to modulate the inflammatory response to cardiopulmonary bypass. Despite conspicuous knowledge and evidence gaps, a rational nutritional support therapy is presented to benefit patients undergoing cardiac surgery.

KEYWORDS:

Cardiopulmonary bypass; Enteral nutrition; High-risk cardiac surgery; Nutrition risk stratification; Organ dysfunctions; Pharmaco-nutrition; Postoperative nutritional management; Supplemental parenteral nutrition; Systemic inflammatory response; Underfeeding

PMID:
28583157
PMCID:
PMC5460477
DOI:
10.1186/s13054-017-1690-5
[Indexed for MEDLINE]
Free PMC Article

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