• Indikasi perubahan nutrisi

• Kenapa dari enteral ke parenteral

• Kadar protein karbo lemak
• ERAS pre durante post op
• Nutrition therapy is the provision of nutrition or
nutrients either orally (regular diet, therapeutic diet,
e.g. fortified food, oral nutritional supplements) or
via enteral nutrition (EN) or parenteral nutrition (PN)
to prevent or treat malnutrition

• the indications for nutritional therapy are

prevention and treatment of catabolism and
malnutrition
• Nutritional care protocols for the surgical patient
must include
– a detailed nutritional and medical history that includes
body composition assessment
– a nutrition intervention plan
– an amendment of the intervention plan, where
appropriate
– clear and accurate documentation assessment of
nutritional and clinical outcome
– resistance exercise whenever possible
• diagnostic criteria for malnutrition according
to two options
– option 1: BMI <18.5 kg/m2
– option 2: combined: weight loss >10% or >5% over
3 months and reduced BMI or a low fat free mass
index (FFMI)
• Enhanced recovery after surgery (ERAS) protocols are
multimodal perioperative care pathways designed to
achieve early recovery after surgical procedures by
maintaining pre-operative organ function and
reducing the profound stress response following
surgery.
• The key elements of ERAS protocols include
preoperative counselling, optimization of nutrition,
standardized analgesic and anesthetic regimens and
early mobilization