Total parenteral nutrition (TPN) is not intimidating…wait a minute, really? How do you assess your patient’s nutritional status? Why is the nutritional assessment important? What are the essential components of the nutritional assessment? What does this have to do with surgery?

Welcome back to CITIZENSURGEON!

In this three part series on surgical nutrition I’m going to cover what you need to know to understand the nutritional aspects of your patient’s surgical care and of course get the information you will need for your exams.

I’ve broken this discussion on surgical nutrition into three segments:

Part One – Understanding Nutritional Assessment – This video!

Part Two – Fluid and Energy – Check it out here:

Part Three – Total Parenteral Nutrition Indications and Design – Check it out here:

In this video on Nutritional Assessment we are going to discuss the approach to your elective and critically ill patients, understand what it means to be at severe nutritional risk and look at the labs that are important in the evaluation of nutritional status.

It is impossible to understand why your patient needs nutrition if you don’t have an adequate understanding of how to assess their nutritional status? When are you going to give TPN? When does your patient need that additional nutrition? When is your patient at severe nutritional risk?

Also, definitely check out the metabolic response to injury videos for a complete explanation of how trauma and injury affects the body’s metabolism.

Part 1 – Pain, hypovolemia and hormones =

Part 2 – Fuel of Injury =

I have a couple of excellent resources for you to review including the ESPEN guidelines, the Hitchhikers Guide to TPN and a link to one of my favorite articles on surgical site infections.

1.). ESPEN Guidelines:

2.). Hitchhiker’s Guide to TPN:

3.). Dr. Leah Neumayer’s paper on multivariable risk for surgical site infections:

After this video you will have an awesome understanding of three things:

1.). How to assess the nutritional status of your patient
2.). How to determine if your patient is at severe nutritional risk
3.). How to determine if your patient needs preoperative nutritional supplementation

As your questions and leave your comments below. Don’t forget to subscribe so you’ll be first to know when the next two videos in this series are available!

Disclaimer: While my aim is to help educate you for the ward, the surgical ICU, the operating room and your exams remember these are not a replacement for your reading, your medical school and residency preparation and most important your own decision making. Good luck and enjoy!

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