RESUMO
INTRODUCTION: It is accepted that even mild nutrient depletion may affect the evolution of the surgical patient. OBJECTIVE: To evaluate the influence of preoperative levels of plasma retinol and zinc on postoperative evolution of surgical patients; to evaluate the influence of inflammation on both level markers. METHODS: Plasma retinol and zinc were determined in 50 patients before programmed gastroenterological surgeries. To detect global malnutrition BMI and weight loss percentage (WL%) were included. C-reactive protein (CRP) was included as inflammation marker. During follow up postoperative complications were recorded. The present analysis was carried out in 43 patients with complete information. RESULTS: Low retinol values (< 20 µg/dl) were founded in 3 cases and low Zn values (< 85 µg/dl) in 20 cases, being 9 of them indicative of severe deficiency (< 70 µg/dl). Postoperative complications were recorded in 17 patients; patients with complications presented lower values of plasma Zn (78.4 ± 25.8 vs. 87.8 ± 25.7 µg/dl) and retinol (36.9 ± 14.5 vs. 49.7 ± 20.6; P = 0.0318) than those with no complications; the number of patients with complications decreased when retinol and Zn ranges increased. No relation between BMI or WL% and appearance of complications was founded; patients with higher WL% were those with higher usual weight. Inflammation affected both markers: retinol dropped from 50.1 ± 17.2 to 44.0 ±20.8 and to 23.7 ± 4.0 µg/dl for CRP ranges of < 0.5, 0.5-3.9 and ≥ 4 mg/dl, respectively (p = 0.0193); levels of zinc fell from 90.1 ± 17.8 to 85.2 ± 29.9 and to 55.0 ± 25.9 µg/dl for the same CRP ranges (P = 0.0195). Zn level influenced retinol level, dropping to 33.1 ± 11.7 µg/dl of retinol in the Zn severe deficiency group (P = 0.0386). CONCLUSIONS: The obtained results confirm the influence of vitamin A and zinc on postoperative evolution of the surgical patient, while alert about the interrelationships among vitamin A, zinc and inflammation, which lead to difficulty to establish the real source of deficiencies. Beyond these difficulties, retinol and zinc plasma levels determine the nutrient availability for the body and appear as promissory markers of surgical risk.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Inflamação/sangue , Complicações Pós-Operatórias/sangue , Vitamina A/sangue , Zinco/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Proteína C-Reativa/análise , Cromatografia Líquida de Alta Pressão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Deficiência de Vitamina A/sangue , Redução de Peso , Adulto JovemRESUMO
Siendo la diarrea una de las complicaciones más frecuentes de los pacientes alimentados con sonda, se intenta evaluar la frecuencia de episodios diarreicos y sus posibles asociaciones. Se estudiaron parámetros nutricionales, tipos de fórmulas, administración, ubicación de la sonda y asociación con fármacos
Assuntos
Albuminas , Diarreia , Nutrição Enteral/efeitos adversosRESUMO
Siendo la diarrea una de las complicaciones más frecuentes de los pacientes alimentados con sonda, se intenta evaluar la frecuencia de episodios diarreicos y sus posibles asociaciones. Se estudiaron parámetros nutricionales, tipos de fórmulas, administración, ubicación de la sonda y asociación con fármacos
