GASTRIC RESIDUAL VOLUME BY MAGNETIC RESSONANCE AFTER INTAKE OF MALTODEXTRIN AND GLUTAMINE: a randomized double-blind, crossover study

Abstract

ContextThe addition of glutamine in preoperative drinks may enhance the benefits of carbohydrate alone.ObjectivesTo evaluate the gastric residual volume after the intake of a beverage containing carbohydrate plus glutamine.MethodsEleven healthy volunteers (24-30 years-old) were randomized in a crossover fashion to intake 400 mL (4h before) and 200 mL (2h before) of a beverage containing either 12.5% maltodextrin (carbohydrate group) or 12.5% maltodextrin plus 15 g of glutamine (glutamine group) in two different moments 7 days apart. Magnetic ressonance was performed to measure the gastric residual volume (mL) 120 and 180 minutes after the last ingestion.ResultsGastric residual volume similar to basal condition was found after 2h and 3h of the intake of beverages. There was no difference in the mean ±SD GRV (mL) found at 120 minutes (carbohydrate group: 22.9±16.6 and glutamine group: 19.7±10.7) and at 180 minutes (carbohydrate group: 21.5±24.1 and glutamine group: 15.1±10.1) between the two drinks.ConclusionsGastric emptying is efficient, and occurs in up to two hours after the intake of a beverage containing either carbohydrate alone or carbohydrate associated with glutamine. The addition of glutamine to carbohydrate-enriched drink seems to be safe for the use up to 2h before an operation. HEADINGS - Gastric emptying. Preoperative care. Carbohydrates. Glutamine. Magnetic resonance imaging.

Efeitos da abreviação do jejum por meio de solução oral enriquecida com carboidrato (cho) em procedimentos hospitalares

“…Durante a análise de vários artigos foi possível observar que os pacientes permanecem mais tempo em jejum do que realmente é pedido, devido a fatores como: atraso nas cirurgias; transferências, falta de profissionais e equipamentos (Chaves, et al, 2019;Nascimento, et al, 2009;Oliveira, et al, 2009;Azevedo, et al, 2017;Lobo, et al, 2009;Brianez, et al, 2014). Callegaro, et al (2010) mostra, em seu trabalho, as experiências de alguns pacientes, como: atrasos, adiamentos ou cancelamentos.…”

Efeitos e segurança do uso pré-operatório de glutamina ou Whey Protein: Uma revisão sistemática

“…Nenhum dos achados mostrou significância estatística, sendo possível deduzir que adicionar glutamina à já bem estabelecida CHO 12,5% é uma conduta segura com esvaziamento gástrico satisfatório em 2 a 3 horas. 17 Já Dock-Nascimento et al e Braga et al avaliaram o VRG através de aspiração de sonda nasogástrica introduzida durante anestesia. Em ambos estudos, a média do VRG entre os grupos foi similar, demonstrando que solução contendo glutamina não aumenta o resíduo gástrico.…”

Perioperative fasting and feeding in adults, obstetric, paediatric and bariatric population: Practice Guidelines from the Indian Society of Anaesthesiologists

“…The 20 studies identified by our search regarding clear liquids intake and gastric volumes did not report any event of aspiration or regurgitation. [ 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 ] The studies were of Low, or Very Low level of evidence. In eight studies, after overnight fasting, one group received water to consume medications and the other, received between 100 and 500 mL water till 2 hours before induction of anaesthesia.…”

“…[ 75 ] Other studies which compared residual gastric volumes and pH after consumption of different kinds of liquids showed comparable gastric volumes and pH (LOE- Very Low to Low). [ 76 77 78 79 80 81 82 ] In a study assessing gastric volumes by gastroscopic aspiration after consumption of 200 mL water, the patients fasted for 40 to 75 min had gastric volumes similar to those fasted for 80-150 min (LOE- Moderate). [ 83 ] An earlier meta-analysis also concluded that there was no evidence that patients given liquid (including water, coffee, fruit juice, clear liquids and other drinks, e.g., isotonic drink, carbohydrate drink) 2-3 h prior to surgery had increased incidence of aspiration or regurgitation (LOE- High).…”

“…[ 85 ] Similarly, comparable residual gastric volumes were found between overnight fasting patients and those receiving 100–500 mL clear liquids 2 h before surgery in other studies conducted in patients scheduled for elective surgical procedures (LOE-Very Low to Low). [ 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 ]…”