Early postoperative undernutrition following aortic valve replacement surgery

Sallé, Agnès; Dalmayrac, Emilie; Baufreton, Christophe

doi:10.1016/j.clnesp.2018.04.009

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…2,17,18 Importantly, a reduced sensation of hunger and caloric intake following surgery can contribute to a catabolic state and a negative energy balance. 19 While early feeding after minor surgery may not have as great an impact, this could still influence overall patient comfort and satisfaction, facilitating an earlier return home and resumption of daily activities.…”

Section: Discussionmentioning

confidence: 99%

Postoperative hunger after outpatient surgery in patients anesthetized with propofol vs sevoflurane: a randomized-controlled trial

Besnier

Perdrix²,

Gillibert

et al. 2020

Can J Anesth/J Can Anesth

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Previous preclinical and preliminary clinical data suggest an appetite-stimulating effect of propofol compared with halogenated drugs. This study compared the effects of propofol with those of sevoflurane on recovery of hunger during the postoperative period. Methods Patients undergoing outpatient transvaginal oocyte retrieval were randomized to propofolremifentanil (propofol group) or sevoflurane-remifentanil (sevoflurane group) anesthesia. The primary endpoint was the time before feeling hungry (C 50/100 mm on a visual analogue scale). Secondary endpoints included plasma levels of ghrelin, leptin, and insulin (ten minutes, one hour, and two hours after anesthesia), caloric intake at first feed, and discharge readiness time. Results In the 58 patients allocated to either the propofol or sevoflurane group, there was no difference in the median [interquartile range] recovery time of hunger (97 [75-138] vs 97 [80-140] min, respectively; median difference, 1; 95% confidence interval [CI], -15 to 14; P = 0.91); caloric intake (245 [200-343] vs 260 [171-314] kcal; P = 0.39); or discharge readiness time (125 [85-153] vs 125

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Section: Discussionmentioning

confidence: 99%

Postoperative hunger after outpatient surgery in patients anesthetized with propofol vs sevoflurane: a randomized-controlled trial

Besnier

Perdrix²,

Gillibert

et al. 2020

Can J Anesth/J Can Anesth

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“…Surgical intervention had a marked impact on the nutritional status of our sample at the 45-day follow-up, when body weight was down by 2.6 ± 2.0 kg, and the proportion of patients at risk for malnutrition had almost doubled. The weight loss is probably due to a lower calorie intake and to hypermetabolism, as also demonstrated by Sallè et al [ 25 ]. This deterioration in the nutritional status of the patients in our sample was reversible, and by 3 months post-surgery their BMI and MNA scores, and the percentage of those at risk of malnutrition were no different from the baseline.…”

Section: Discussionmentioning

confidence: 53%

Surgical aortic valve replacement in elderly patients: effects on physical performance, cognitive function and health-related quality of life

et al. 2021

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Background Surgical aortic valve replacement (SAVR) is still the gold standard for treating aortic valve stenosis (AVS). Its effectiveness has been extensively examined in terms of perioperative mortality, but its impact on overall health has received much less attention. Aims To assess the physical performance, cognitive status, and health-related quality of life of elderly patients undergoing SAVR, in the short, medium and long term. Methods This single-center prospective study enrolled patients aged > 70 years who underwent isolated SAVR for severe AVS. Data were collected on each participant’s clinical status, physical performance, cognitive status, mood, and health-related quality of life. This multidimensional geriatric assessment was performed before surgery (T0), and again at 45 days (T1), 3 months (T2), 6 months (T3), and 12 months (T4) post-surgery. Baseline (T0) and follow-up (T2-T4) data were compared separately for patients grouped by gender using paired t-tests. Results Data from a total of 35 patients were analyzed. Compared with the baseline (T0), nutritional status worsened at T1, then gradually improved through to T4. Physical performance, mood, and health-related quality of life improved significantly after surgery. Cognitive function showed no change through to T3, but then deteriorated at T4. Conclusions Our results show that SAVR in patients over 70 years of age has a positive impact on nutrition, mood, and health-related quality of life. Cognitive function was not negatively affected in the short and medium term, although it deteriorated in the long term. SAVR also had a positive impact on the physical performance of our sample.

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“…Wilmore DW reported that a positive fluid balance of >3000 mL up to 24 hrs post-surgery was a reliable predictor of long-term mechanical ventilation, of >3d of ICU stay, and of longer hospital stay [ 19 ]. On the other hand, the average weight of patients was found to increase by 2 kg and the median gain for ECW was 1.1 kg [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The non-invasive bioelectrical impedance analysis (BIA) remains a reliable technique, easily available at the bedside, having the potential to independently quantify intracellular and extracellular fluid volumes and the fat-free mass (FFM) and fat mass (FM) percentages [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Endothelial Damage and Muscle Wasting in Cardiac Surgery Patients

Stavrou¹,

Tzikos²,

Menni³

et al. 2022

Cureus

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This is a post-hoc analysis to assess the effect of anesthesia, surgical trauma, and extracorporeal circuit on endothelial integrity, microvascular permeability, and extracellular fluid balance, as well as on skeletal muscle catabolism, in patients undergoing elective cardiac surgery. We included 127 well-nourished patients undergoing "on-pump" elective cardiac surgery. One day prior to surgery (D0) and again on postoperative day 7 (POD7), body mass index, body composition assessment, hand-grip strength (HGS), and mid-upper arm muscle circumference (MAMC) were measured. Patients were assigned to early recovery (ER) and late recovery (LR) groups, depending on the duration of ICU stay (cut-off 48 hours). The magnitude of change (Δ) in all parameters studied was assessed in ER versus LR groups, regarding (i) epithelial tissue dysfunction (Δ-Extra-Cellular Water percentage (Δ-ECW%), Δ-Phase Angle (Δ-PhA)), (ii) skeletal muscle mass catabolism (Δ-Skeletal muscle mass reduction%, Δ-Hand Grip Strength (Δ-HGS) and Δ-Mid Upper-Arm Muscle Circumference (Δ-MAMC)). Baseline measurements were similar in both groups. A significant difference was observed in all Δ-parameters studied (Δ-ECW%, Δ-PhA and muscle catabolism, Δ-HGS, Δ-MAMC), the worse results being correlated to the LR group. The results raise the issue that patients with early recovery may silently have pathological conditions, continuing even on the day of discharge -further research should be planned.

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Early postoperative undernutrition following aortic valve replacement surgery

Cited by 5 publications

References 23 publications

Postoperative hunger after outpatient surgery in patients anesthetized with propofol vs sevoflurane: a randomized-controlled trial

Postoperative hunger after outpatient surgery in patients anesthetized with propofol vs sevoflurane: a randomized-controlled trial

Surgical aortic valve replacement in elderly patients: effects on physical performance, cognitive function and health-related quality of life

Endothelial Damage and Muscle Wasting in Cardiac Surgery Patients

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