Nutrition is an important factor in determining the results of liver transplantation. Among liver transplant candidates, malnutrition is prevalent and linked to higher rates of morbidity and mortality. This review highlights the significance of prehabilitation, provides helpful guidance to maximize recovery and long-term health in transplant patients, and describes evidence-based approaches for nutritional assessment and management both before and after liver transplantation.

Nutritional support is essential in caring for pediatric surgical patients, as it directly impacts not only immediate recovery and long-term outcomes, but also growth and development. This chapter reviews the physiologic differences and energy requirements in children, anthropometric methods for evaluating nutritional status, specific pediatric conditions affecting nutrition, the roles of micronutrients and vitamins, and some pediatric-specific nuances associated with both enteral and parenteral feeding. It emphasizes early nutritional intervention and multidisciplinary collaboration to optimize outcomes and enhance surgical recovery.

Parenteral nutrition (PN) is a critical intervention for surgical patients who cannot meet nutritional needs via the gastrointestinal tract. This article explores the principles of PN through the lens of When, How, and Why, providing evidence-based guidance for timing, administration, and monitoring. Emphasis is placed on optimizing outcomes, minimizing complications, and addressing ethical considerations in resource-limited settings.

Immunonutrition, once thought to reduce infections in critically ill patients, faced scrutiny in the early 2000s following large trials that showed limited benefits and potential harm, particularly from formulas supplemented with arginine and glutamine. Newer evidence on immune-enhancing diets (IEDs) has prompted a shift toward individualized, precision-based nutrition strategies. Omega-3 fatty acids remain promising, especially in patients with traumatic brain injury or critical illness-induced muscle-wasting. Current guidelines recommend selective use of IEDs, such as in patients with cancer or chronic inflammatory conditions.

Early enteral nutrition (EN) in critically ill patients receiving vasopressors remains controversial due to concerns about gut ischemia and feeding intolerance. Current evidence supports a cautious, individualized approach emphasizing resuscitation status, vasopressor dose, and feeding strategy. Observational and randomized trials suggest trophic EN may be safe and beneficial in patients postresuscitation on low-to-moderate norepinephrine doses, whereas full-dose EN on higher-dose vasopressors increases gastrointestinal complications. Practical recommendations include gastric-only trophic feeding, slow advancement, and vigilant intolerance monitoring. Emerging predictive tools and guidelines advocate for trophic EN during resuscitated shock, highlighting the urgent need for validated bedside decision aids and randomized trials.

The paradigms of nutrition in the acutely injured or ill patient are changing as interest in the subject has blossomed, particularly over the last few years. The previously ingrained indications for maintaining nil-per-os status for surgical patients have become narrower, and clinicians are more comfortable with establishing early access for nutrition. We are beginning to see the benefits in outcomes for early nutrition in this patient population, as well. Here the authors present the most innovative and up-to-date recommendations for nutrition in emergency general surgery and trauma patients.

There are a variety of methods for obtaining enteral access for patients requiring short- or long-term enteral feeding. This article reviews indications, contraindications, and techniques for placement of nasoenteric access, percutaneous endoscopic gastrostomy, open and laparoscopic gastrostomy and jejunostomy, and gastrojejunostomy. The diagnosis and management of complications from these procedures is also discussed as are pearls and pitfalls for each technique.

In the outpatient management of type 2 diabetes mellitus, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are proven to benefit long-term glycemic control and reduce complications related to chronic inflammation. Emerging clinical data suggest that GLP-1 RAs may serve as an alternative or complement to insulin for glycemic management in hospitalized patients. Preclinical studies indicate that GLP-1 RAs influence the inflammatory response in models of acute inflammation, including ischemia-reperfusion injury, sepsis-induced vascular dysfunction, acute lung injury, and acute kidney injury. Although aspiration is a potential risk linked to GLP-1 RAs, it can be minimized by following established medical society guidelines.

Malnutrition is highly prevalent among cancer patients, particularly those with head and neck and gastrointestinal malignancies, older age, and advanced disease. It results from disease burden, treatment-related factors, prolonged hospitalization, and unrecognized nutrition-impact symptoms, leading to poor surgical outcomes, increased complications, mortality, and health care costs. Despite being a modifiable perioperative risk factor, nutritional status is often overlooked. Comprehensive preoperative nutritional screening, assessment, and intervention-guided by established tools and the Nutritional Care Process-are essential. Early identification and management of malnutrition, sarcopenia, and cachexia can optimize surgical recovery, improve quality of life, and enhance overall cancer outcomes.

As the global population ages, more older adults undergo surgery, a group particularly vulnerable to postoperative complications. Malnutrition remains prevalent among geriatric patients and is strongly linked to increased morbidity, including infections and poor wound healing. Sarcopenia, the loss of muscle mass and function, frequently coexists with malnutrition, creating a detrimental cycle that worsens surgical outcomes. Early identification is essential, and validated screening tools such as the Mini Nutritional Assessment-Short Form and the Malnutrition Universal Screening Tool help detect patients at risk. Implementing routine preoperative nutritional assessment and targeted intervention can significantly improve recovery and reduce length of stay.

Malnutrition is a prevalent and modifiable risk factor in surgical patients, strongly associated with increased postoperative complications, mortality, and prolonged hospital stays. The risk is especially high among patients with cancer, chronic diseases, and those undergoing major gastrointestinal or hepatobiliary procedures. Surgery itself exacerbates nutritional deficits through catabolic and inflammatory responses, increasing the risk of sarcopenia. Early identification using validated screening tools (MUST, NRS-2002, SGA, CT-based assessment) is crucial for optimizing care. Preoperative and perioperative nutritional support, particularly when integrated into ERAS protocols, significantly reduces complications, shortens hospital stays, and improves recovery and long-term outcomes across diverse high-risk patient populations.