M Julia Ocón Bretón, M José Tapia Guerrero, José Manuel Ramírez Rodriguez, Carlos Peteiro Miranda, María D Ballesteros Pomar, Francisco Botella Romero, Miguel Ángel Martínez Olmos, Luis Miguel Luengo Pérez, Emilia Cancer Minchot, Katherine García Malpartida, Juan José López Gómez, Ana Zugasti Murillo, Julia Álvarez Hernández, Irene Bretón Lesmes
Journal: Endocrinologia, diabetes y nutricion 2022;69(2):98-111
PMID: 35256065
BACKGROUND
The Enhanced Recovery After Surgery (ERAS) care pathways include evidence-based items designed to accelerate recovery after surgery. Interdisciplinarity is one of the key points of ERAS programs.
OBJECTIVE
To prepare a consensus document among the members of the Nutrition Area of the Spanish Society of Endocrinology and Nutrition (SEEN) and the Spanish Group for Multimodal Rehabilitation (GERM), in which the goal is to homogenize the nutritional and metabolic management of patients included in an ERAS program.
METHODS
69 specialists in Endocrinology and Nutrition and 85 members of the GERM participated in the project. After a literature review, 79 statements were proposed, divided into 5 sections: 17 of general characteristics, 28 referring to the preoperative period, 4 to the intraoperative, 13 to the perioperative and 17 to the postoperative period. The degree of consensus was determined through a Delphi process of 2 circulations that was ratified by a consistency analysis.
RESULTS
Overall, in 61 of the 79 statements there was a consistent agreement, with the degree of consensus being greater among members of the SEEN (64/79) than members of the GERM (59/79). Within the 18 statements where a consistent agreement was not reached, we should highlight some important nutritional strategies such as muscle mass assessment, the start of early oral feeding or pharmaconutrition.
CONCLUSION
Consensus was reached on the vast majority of the nutritional measures and care included in ERAS programs. Due to the lack of agreement on certain key points, it is necessary to continue working closely with both societies to improve the recovery of the surgical patients.
Copyright © 2021 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.
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