Pp232 Cellular Mechanisms Underlying the Protective Effects of Preoperative Carbohydrate Loading: A Randomised Study Investigating Mitochondrial Function, Gene and Protein Expression (Nct00662376)

Awad, Sherif; Constantin-Teodosiu, D; Constantin, Despina; Fearon, Kenneth C. H.; Macdonald, I. A.; Lobo, Diana

doi:10.1016/s1744-1161(10)70307-0

Cited by 11 publications

(17 citation statements)

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“…A similar finding was also reported by Awad et al [28] in patients undergoing laparoscopic cholecystectomy, although the preoperative beverage used in their study contained glutamine and antioxidants as well, making the interpretation of their data more uncertain. In addition, an RCT from China after radical gastrectomy [29] reported that improved postoperative metabolism from POC was associated with improved mitochondrial function and less marked structural changes in the mitochondria, as shown by transmission electron microscopy.…”

Section: Mechanisms Behind Effects Of Preoperative Oral Carbohydratessupporting

confidence: 86%

Preoperative oral carbohydrate therapy

Nygren

Thorell

Ljungqvist

2015

Current Opinion in Anaesthesiology

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Purpose of review Management of the postoperative response to surgical stress is an important issue in major surgery. Avoiding preoperative fasting using preoperative oral carbohydrates (POC) has been suggested as a measure to prevent and reduce the extent to which such derangements occur. This review summarizes the current evidence and rationale for this treatment. Recent findingsA recent review from the Cochrane Collaboration reports enhanced gastrointestinal recovery and shorter hospital stay with the use of POC with no effect on postoperative complication rates. Multiple randomized controlled trials demonstrate improved postoperative metabolic response after POC administration, including reduced insulin resistance, protein sparing, improved muscle function and preserved immune response. Cohort studies in patients undergoing major abdominal surgery have shown that the use of POC as part of an enhanced recovery after surgery protocol is a significant predictor for improved clinical outcomes. SummaryAvoiding preoperative fasting with POC is associated with attenuated postoperative insulin resistance, improved metabolic response, enhanced perioperative well-being, and better clinical outcomes. The impact is greatest for patients undergoing major surgeries.

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Section: Mechanisms Behind Effects Of Preoperative Oral Carbohydratessupporting

confidence: 86%

Preoperative oral carbohydrate therapy

Nygren

Thorell

Ljungqvist

2015

Current Opinion in Anaesthesiology

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“…Adding hydrolyzed proteins to a carbohydrate-based drink was reported by Henriksen et al They found a significant decrease in the activity of muscular glycogen synthase (a rate-limiting enzyme for glucose storage as glycogen) in patients who received preoperative hydrolyzed soy protein supplemented carbohydrate-rich drinks before undergoing major abdominal surgery. In accordance, other studies also found either clinical or metabolic benefits with either glutamine or whey protein supplemented carbohydrate-rich preoperative drinks [15,16]. Pea protein hydrolysate has rapid gastric emptying and is probably more effective than soybean hydrolysate.…”

Section: Discussionsupporting

confidence: 68%

“…These new formulas may improve postoperative muscle strength [11] and reduce fatigue, anxiety, and discomfort [12] as well as lower the endocrine-metabolic response to trauma [13,14]. The addition of glutamine to these drinks improved the inflammatory response and nitrogen balance after laparoscopic cholecystectomy in one study [15] and the hepatic and mitochondrial metabolic response in two other recent studies [16,17].…”

Section: Introductionmentioning

confidence: 99%

Shrinking preoperative fast time with maltodextrin and protein hydrolysate in gastrointestinal resections due to cancer

et al. 2013

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“…In contrast, a CHO diet reduces urea production 37 . However, following the ingestion of either protein or amino acids, not only is urea formed but there is also an enhancement of both hepatic glycogen content and the plasma levels of amino acids, mainly GLN 22 . Therefore, GLN plus a CHO‐enriched preoperative beverage can have a beneficial effect on the patient.…”

Section: Discussionmentioning

confidence: 99%