Study | Patient population | Protocol for early nutrition intervention | Control |
---|---|---|---|
Beier-Holgersen and Boesby, 1996 | 60 patients with gastrointestinal disease undergoing abdominal surgery (87% underwent colorectal surgery). | Start within 4 h of surgery (POD 0): 60 mls of protein drink (Nutricia Nutridrink, Orange) every h, for total of 600 ml. POD 1: 1000 ml of protein drink; POD 2: 1400 ml protein drink; POD 3 and 4: 1800 ml protein drink. | Placebo (water with orange flavor) following same protocol as early protein drink group. |
Carr et al., 1996 | 28 patients undergoing intestinal resection distal to the ligament of Treitz. | Start within 2 to 3 h of surgery (POD 0): 25 ml/h EN (Fresubin, Fresenius) via N-J tube. Rate increased by 25 ml every 4 h until target of 35 ml/kg/day achieved. | NPO until passage of flatus. |
Lau et al., 2014 | 111 elective colorectal surgery patients. | Start POD 1: Solid diet that left minimal residue in the lower intestinal tract after digestion and absorption. | Start POD 1: Clear liquids, specifically omitting all solids (ex., milk, and fruit juice with pulp). POD 2: Advanced to solid diet. |
Minig et al., 2009 | 51 gynecologic oncology patients. (Over 70% also had rectosigmoid resection in addition to hysterectomy.) | Start POD 0: Clear fluids and other liquids (tea, apple juice, etc.). If fluids tolerated, progress to regular diet by end of POD 1. | NPO until resolution of ileus. |
Mulrooney et al., 2005 | 73 patients undergoing colonic resection | Start within 24 h of surgery: 25 ml/h EN (Nutrison Standard, Nutricia) via N-J tube; POD 2: 50 ml/h EN; POD 3: 75 ml/h: POD 4: EN increased to calculated nutritional targets. | NPO until passage of flatus. |
Ortiz et al., 1996 | 190 patients undergoing elective colon and rectal surgery. | Early removal of NG tube with clear liquids on POD 0 followed by regular diet on POD 1. | NPO until resolution of ileus. |
Shen 2013 | 82 patients with colorectal cancer undergoing surgery. | Start POD 1: 200 mls 0.9% Saline and 200 ml EN; POD 2: 500 to 1000 ml EN; POD 3: 1500 to 2000 ml of EN; POD 4: 2000 ml EN continued until POD 7. | Start standard PN POD 2: standard PN continued until POD 7. |
Stewart et al., 1998 | 88 patients undergoing elective colorectal resection with anastomosis, without stoma formation. | Start within 4 h of surgery (POD 0): free fluids; POD 1: Solid diet. | NPO until passage of flatus or bowel movement. |