Page 184 - Hospital Authority Convention 2017

Parallel Sessions
HOSPITAL AUTHORITY CONVENTION 2017

PS5.4 Collaborative Service Programmes 09:00 Room 423 & Room 424

Nutrition Support in Enhanced Recovery after Surgery
Kan IYM
Dietetics Department, Prince of Wales Hospital, Hong Kong
Enhanced Recovery after Surgery (ERAS) is an evidence-based multi-modal and multi-disciplinary pathway to reduce
surgical stress and limit post-surgical morbidity. ERAS, recommends pre-operative nutrition assessment and intervention,
relaxing pre-operative fasting to two to four hours, rather than traditional 12 hours as well as introducing carbohydrate
loading before operation. It is known to attenuate insulin resistance, minimise muscle and protein loss, and improve patient
comfort. Another element for ERAS is the initiation of early post-operative diet and fluid. In post-operative period, nutrition
support is introduced in the form of diet and/or oral nutrition supplements. It can be started as early as 24 hours after
surgery. Oral feeding is usually started with liquid and transited to regular diet thereafter. Early oral or enteral nutrition has
been demonstrated to be safe and preserves post-operative nutrition profile.

In New Territories East Cluster, ERAS programme has been initiated in selected surgical patients. Dietitians are actively
involved in the care of patients before, during and after surgery. In the pre-operative period, patients with malnutrition risk
are referred to dietitian for assessment and counselling. Nutrition assessment and optimisation of nutrition status before
operation is crucial to enhance successful surgery outcome. Referred patients were followed up throughout their hospital
journey including inpatient and post-discharge to ensure rapid hydration and nourishment post-operation and ongoing
nutrition support after discharged.

Wednesday, 17 May

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