Nutrition and Metabolism in the Surgical Patient

Part 1 General considerations: body composition; intestinal digestion and absorption of nutrients; mediators, hormones, and control of metabolism - regulation of protein, carbohydrate, and lipid metabolism in critical illness; energy metabolisml; growth factors. Part 2 Intermediary metabolism: protein and amino acid metabolism; carbohydrates; plasma lipoproteins and intravenous lipid emulsions; vitamins; essential trace metals - deficiencies and requirements; two dozen syndromes - pattern recognition in diagnosis and treatment of fluid and electrolyte disorders; glutamine as a metabolic intermediate; intestinal fluids - implications for improvement of intestinal growth and function; arginine; nutrition in wound healing; nitric oxide; translocation as it applies to metabolism; omega-3 and other polyunsaturated fatty acids - modulation of the inflammatory response. Part 3 Patient evaluation: nutritional assessment - the assessment of the nutritional and metabolic status of surgical patients. Part 4 Physiologic response: starvation - metabolic and physiologic responses; metabolic response to trauma and infection; nutrition and neoplasma; changes in immunologic function; nutritional support in hepatic failure; nutritional management in acute renal failure; nutrition of heart and lung; special needs of the paediatric patient. Part 5 Specific modes of therapy: parenteral nutrition; enteral nutrition; critical evaluation of results - cost and benefit of nutrition support.