The malnourished patient
The average lead time for ambulatory surgery is 4 to 6 weeks, which
is long enough to improve the nutritional status of malnourished
patients. Assess the nutritional status of patients as soon as cases are
scheduled (see sidebar). If a nutritional intervention is needed, begin
it immediately.
Overall protein intake is more important than total caloric intake in
malnourished patients, who should ingest more than 1.2 g/kg/d of pro-
tein. Patients who need nutritional help should therefore take high pro-
tein-based supplements as well as an immune nutrition supplement,
which in many studies has been shown to reduce the risk of post-op
infection.
Patients can drink over-the-counter high-protein (>18 grams/protein
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