1. J Hum Nutr Diet. 2018 Apr;31(2):151-167. doi: 10.1111/jhn.12486.

Epub 2017 Jun

6.

A systematic review of feeding practices among postoperative patients: is

practice in-line with evidenced-based guidelines?

Rattray M(1)(2), Roberts S(2)(3), Marshall A(2)(3)(4), Desbrow B(1)(2).

Author information:
(1)School of Allied Health Sciences, Griffith University, Southport, QLD,
Australia.
(2)Menzies Health Institute Queensland, Griffith University, Southport, QLD,
Australia.
(3)National Centre of Research Excellence in Nursing (NCREN), Griffith
University, Southport, QLD, Australia.
(4)School of Nursing and Midwifery, Griffith University, Southport, QLD,
Australia.

BACKGROUND: Early oral feeding after surgery is best practice among adult,
noncritically ill patients. Evidenced-based guidelines (EBG) recommend commencing
liquid and solid feeding within 24 h of surgery to improve patient (e.g. reduced
morbidity) and hospital (e.g. reduced length of stay) outcomes. Whether these EBG
are adhered to in usual clinical practice remains unknown. The present study
aimed to identify the time to commencement of first oral feed (liquid or solid)
and first solid feed among postoperative, noncritically ill, adult patients.
METHODS: MEDLINE, CINAHL, SCOPUS and Web of Science databases were searched from
inception to June 2016 for observational studies reporting liquid and/or solid
feeding practices among postoperative patients. Studies reporting a mean/median
time to first feed or first solid feed within 24 h of surgery or where ≥75% of
patients were feeding by postoperative day one were considered in-line with EBG.
RESULTS: Of 5826 articles retrieved, 29 studies were included. Only 40% and 22%
of studies reported time to first feed and time to first solid feed in-line with
EBG, respectively. Clear and free liquids were the first diet types commenced in
86% of studies. When solids were commenced, 44% of studies reported using various
therapeutic diet types (e.g. light) prior to the commencement of a regular diet.
Patients who underwent gastrointestinal procedures appeared more likely to
experience delayed postoperative feeding.
CONCLUSIONS: Our findings demonstrate a gap between postoperative feeding
evidence and its practical application. This information provides a strong
rationale for interventions targeting improved nutritional care following
surgery.

© 2017 The British Dietetic Association Ltd.

DOI: 10.1111/jhn.12486
PMID: 28589624