Perioperative metabolic changes in patients undergoing cardiac surgery
Abstract:
Perioperative metabolic changes in cardiac surgery patients are not only induced by tissue injury and extracorporeal circulation .the Pathophysiolgy changes include increased oxygen consumption and energy expenditure, increases secretion of adrenocorticotrophic hormone, cortisol ,epinephrine, norepinephrine, insulin, and growth hormone ad decrease total tri- iodothyronine levels. Easily measurable metabolic consequences of these changes include hyperglycemia, hyperlactatemia, increased aspartate, glutamate and free fatty acid concentration, hypokalemia, increase production of inflammatory cytokines and increase consumption of complement and adhesion molecules. Nutritional risk before elective cardiac surgery-defined as preoperative unintended pathologic weight loss/low amount of food intake in the preceding week of low body mass index-is related to adverse postoperative outcome. Improvement in surgical techniques, anesthesia and perioperative management have been designed to minimize the stressful stimulus to catabolism , thereby slowing the wasting process to the point where much less nutrition is required to meet metabolic requirements .Early nutrition in cardiac surgery is safe and well tolerated.
Original article from Nutrition- (2010- 1–5)
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