Relationship Between Perioperative Oral Nutritional Supplementation And Clinical Outcome In Patients Undergoing Cardiac Surgery

Objective:1.Through nutrition risk screening,assess the nutritional status of inpatients in cardiac surgery,and study the incidence of malnutrition in preoperative patients with cardiac surgery.2.To study perioperative period of cardiac surgery in patients with malnutrition risk give different oral nutritional supplements,in order to compare postoperative recovery.Methods:Patients who underwent elective thoracotomy were enrolled in our hospital from January 2018 to December 2018.Risk screening was conducted within 24 hours after admission,and 150 patients with nutritional risk were screened.After obtaining informed consent,they were randomly assigned to three groups.Group A: Oral nutritional supplementation(ONS)was given before surgery,and postoperatively continued;Group B: ONS was not given before surgery,only ONS was given after surgery;Group C: ONS was not given during perioperative period.The total protein(ALB)and total protein(PA)were measured on the day of admission to the ICU,and the corresponding clinical data were: ICU treatment time,postoperative hospital stay,assisted breathing time,The data of auxiliary time,dopamine dosage,postoperative weight loss,and total hospitalization cost were recorded and analyzed.Result:1.A total of 760 inpatients with cardiac surgery who met the requirements from January 2018 to December 2018 were enrolled in the study.Among them,480(63.2%)were coronary heart disease patients and 195(25.6%)were rheumatic patients.45 cases of congenital heart disease(accounting for 5.9%),40 cases of myxoma(accounting for 5.3%).Among them,158 patients with nutritional risk who met the enrollment criteria had a nutritional risk of 20.79%.The prevalence of nutritional risk before rheumatic heart disease,including 2 cases,was 35.9%;the incidence of coronary heart disease nutritional risk,including 6 cases,16.3%;the incidence of congenital heart disease nutrition risk was 13.3%;the incidence of myxoma nutrition risk was 10.0%.Due to the preoperative transfer to the department,the need to stabilize the condition and then hospitalization,the postoperative condition was critical,assisted breathing for more than 24 hours and 8 cases of nasal feeding diet and intravenous high nutrition patients,the final inclusion of 150 patients in this study,including coronary heart disease.A total of 72 patients(48%),68 patients with rheumatic heart disease(45.3%),6 patients with congenital heart disease(4%),4 patients with myxoma(2.7%).There were no statistically significant differences in age,gender,disease composition,BMI,and nutrition-related laboratory parameters between the three groups(P>0.05).2.Patients who received oral nutritional supplements during the perioperative period were significantly less likely to have postoperative weight loss and serum protein reduction than those who did not receive oral nutritional supplementation.The total protein before surgery was lower than that before surgery,and the reduction was greater in the group without oral nutrition supplement.Group A and B patients who received oral nutritional supplements during perioperative period,serum total protein(ALB),total serum pre-protein(PA),ICU treatment time,postoperative hospital stay,assisted breathing time.The clinical indicators such as assisted breathing time,dopamine dosage,and postoperative weight loss were superior to those in group C without nutritional supplementation.In group A,the time of ICU treatment and postoperative hospital stay were the shortest;group C without nutrition intervention had the longest time.Oral nutritional supplementation can effectively shorten ICU treatment time and postoperative hospital stay;there are significant differences in ventilator assist time,dopamine dose,postoperative weight loss between the three groups,and the lowest meangroup A.However,there is no significant difference with the B group.Perioperative application of oral nutritional supplements can shorten the ventilator assist time,reduce the application of vasoactive drugs,reduce postoperative weight loss,and accelerate patient recovery.There was no significant difference between the three groups of hospitalization expenses.Due to shortened postoperative hospital stay,ventilator assist time,ICU treatment time,the whole application of ONS group A and postoperative ONS group B,although the cost of oral nutritional supplements increased,but the overall cost did not increase significantly.Conclusion: In cardiac surgery,thoracotomy increases the risk of nutritional risk in patients.For patients with nutritional risk during perioperative period of cardiac surgery,oral nutrition supplementation before and after surgery can improve the nutritional status of patients and accelerate the recovery of patients compared with patients who do not give oral nutritional supplements.Patients who received oral nutritional supplements during the perioperative period were able to effectively reduce ICU treatment time and postoperative hospital stays compared with patients who received oral nutritional supplements only after surgery.