Caso clínico : abordaje nutricional en paciente con restitución intestinal.

Abstract

Clinical nutrition constitutes a vital element in the management of surgical patients with chronic conditions, as hospital malnutrition correlates with an increased risk of complications, delayed recovery, and higher mortality rates. This report delineates the case of a 62-year-old female patient with a documented history of type II diabetes mellitus and hypertension, who was admitted for intestinal transit restoration following a colostomy. Throughout the perioperative period, the patient required an individualized nutritional plan based on the Mifflin-St Jeor formula, complemented by the “rule of thumb" method for caloric estimation, resulting in an energy requirement of 1562.4 kcal/day and a protein intake of 1.3 g/kg of body weight. Assessment using the Subjective Global Assessment (SGA) determined a state of moderate malnutrition (SGA=B), justifying the implementation of parenteral nutrition in the immediate postoperative period to ensure a safe provision of energy and nutrients. Subsequently, a progressive transition to a soft mechanical diet, until reaching a complete diet, was carried out, adjusted to the patient’s metabolic condition. This case underscores the significance of adopting a comprehensive nutritional strategy in patients undergoing intestinal transit restoration. Early identification of nutritional risks and the delivery of tailored nutritional support are vital in minimizing complications, maintaining muscle mass, and enhancing postoperative recovery. The participation of a clinical dietitian is essential in the formulation, implementation, and evaluation of the therapeutic plan, thereby ensuring safe and evidence-based care.