special subjects
Postoperative Care
Loss of muscle mass (sarcopenia)
Loss of muscle mass (sarcopenia) and strength occur in all patients who require prolonged bed rest. With complete bed rest, young adults lose about 1% of muscle mass/day, but older patients lose up to 5%/day because growth hormone levels decrease with age. Avoiding sarcopenia is essential to recovery. Thus, patients should sit up in bed, transfer to a chair, stand, and exercise as much as and as soon as is safe for their surgical and medical condition. Nutritional deficiencies may also contribute to sarcopenia. Thus, nutritional intake of patients on complete bed rest should be optimized. Oral intake should be encouraged, and Enteral Tube Nutrition or, rarely, 