Современная организация нутритивной поддержки у детей с хирургической патологией

Purpose . The article deals with modern possibilities of nutritional support following major abdominal surgeries. The author explains why parenteral nutrition and enteral feeding are necessary. Materials and methods . A surgery results in the disturbance of digestion and absorption processes. Following major surgeries, normal functioning of the GIT is more disturbed in children as compared to adults decreasing digestion, absorption and metabolism of administered nutrients. It is necessary to be aware of the principal pathophysiological changes that occur during the post-operational period to arrange for enteral feeding. Resection of the small and large bowels results in the increased secretion of substances into the GIT. The lesser is the residual intestinal length, the more fluid enters the bowel by means of secretion. A doctor comes across the issue of non-correspondence between a significant growth of a child’s need in energy and nutrients and a severe drop of functional intestinal capabilities. Discussion . A doctor needs to provide a child with any necessary nutrients considering organismbased morpho-functional and metabolic disturbances. Due to negative metabolic changes in a surgical pathology, the nutritional problem is treated as an important constituent of posttraumatic management of patients. These sick children have a negative nitrogen balance even when enteral feeding is possible; it means that the basal metabolism is increased and a child has an increased need in nutrients and energy. Conclusion . The principal indication for using nutrition therapy in pediatric practice includes an early restoration postoperative period when usual delivery of nutrients is difficult and/or contraindicated. Surgeons can use modern technologies providing children who underwent a surgery with nutritional support.