The Principles and Practice of Nutritional Support
Item
Title
The Principles and Practice of Nutritional Support
Description
Published in 1959, Dr. Francis D. Moore’s textbook on Metabolic Care of the
Surgical Patient was the only volume on the subject by a single author. It used case
studies to cover the years from 1941 to 1952 and was followed by a textbook based
on his publications and lectures during that time.
Much has changed since then. In a seminal 1968 article, Stanley Dudrick, M.D.,
and colleagues showed that total parenteral nutrition (TPN) accelerated healing and
improved prognoses in patients with poorly functional gastrointestinal tracts and
catabolic disease processes. Their research, fi rst in 6 beagle puppies and then in a
clinical trial in 30 patients with chronic gastrointestinal disease, established TPN as
a valuable way to address malnutrition in hospitalized patients (1).
The second advance came in 1974, when Bistrian et al. (2) found that approximately 50% of surgical patients in an urban hospital had protein-calorie malnutrition. This high prevalence spurred the development of dedicated nutrition support
services to prevent malnutrition in critically ill patients. At that time, the stress
response to injury and infection in those with baseline malnutrition was of particular
concern (3).
Surgical Patient was the only volume on the subject by a single author. It used case
studies to cover the years from 1941 to 1952 and was followed by a textbook based
on his publications and lectures during that time.
Much has changed since then. In a seminal 1968 article, Stanley Dudrick, M.D.,
and colleagues showed that total parenteral nutrition (TPN) accelerated healing and
improved prognoses in patients with poorly functional gastrointestinal tracts and
catabolic disease processes. Their research, fi rst in 6 beagle puppies and then in a
clinical trial in 30 patients with chronic gastrointestinal disease, established TPN as
a valuable way to address malnutrition in hospitalized patients (1).
The second advance came in 1974, when Bistrian et al. (2) found that approximately 50% of surgical patients in an urban hospital had protein-calorie malnutrition. This high prevalence spurred the development of dedicated nutrition support
services to prevent malnutrition in critically ill patients. At that time, the stress
response to injury and infection in those with baseline malnutrition was of particular
concern (3).