Preoperative administration of oral carbohydrate-rich solutions: Comparison of glucometabolic responses and tolerability between patients with and without insulin resistance

Can, Mehmet Fatih; Yağcı, Gökhan; Dağ, Birgül; Öztürk, Erkan; Gorgulu, Semih; Şimşek, Abdurrahman; Tufan, Turgut

doi:10.1016/j.nut.2008.07.021

Cited by 25 publications

(23 citation statements)

References 19 publications

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“…Oral and intravenous (IV) modalities are also effective at reducing insulin resistance and hyperglycemia [14]. Carbohydrate loading is a standard-of-care technique in ERAS programs that is safe in diabetic populations and can be given up to 2 h before surgery [14].…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Carbohydrate loading is a standard-of-care technique in ERAS programs that is safe in diabetic populations and can be given up to 2 h before surgery [14]. …”

Section: Evidence Synthesismentioning

confidence: 99%

“…Auditing ERAS programs can help assess compliance with recommended pathways, which is necessary to ensure successful implementation and evaluate the effect on clinical and financial outcomes [14]. Auditing can also help ensure that ERAS programs continue to be as dynamic as possible by adapting pathways that enable the development of individualized guidelines specific to different surgical modalities, disease states, or institutions [14]. …”

Section: Evidence Synthesismentioning

confidence: 99%

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Enhanced Recovery after Urological Surgery: A Contemporary Systematic Review of Outcomes, Key Elements, and Research Needs

et al. 2016

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Context Enhanced Recovery after Surgery (ERAS) programs are multimodal care pathways that aim to decrease intra-operative blood loss, decrease postoperative complications, and reduce recovery times. Objective To overview the use and key elements of ERAS pathways, and define needs for future clinical trials. Evidence acquisition A comprehensive systematic MEDLINE search was performed for English language reports published before May 2015 using the terms “postoperative period,” “postoperative care,” “enhanced recovery after surgery,” “enhanced recovery,” “accelerated recovery,” “fast track recovery,” “recovery program,” “recovery pathway”,“ERAS ” , and “urology” or “cystectomy” or “urologic surgery.” Evidence synthesis We identified 18 eligible articles. Patient counseling, physical conditioning, avoiding excessive alcohol and smoking, and good nutrition appeared to protect against postoperative complications. Fasting from solid food for only 6 h and perioperative liquid – carbohydrate loading up to 2 h prior to surgery appeared to be safe and reduced recovery times. Restricted, balanced, and goal-directed fluid replacement is effective when individualized, depending on patient morbidity and surgical procedure. Decreased intraoperative blood loss may be achieved by several measures. Deep vein thrombosis prophylaxis, antibiotic prophylaxis, and thermoregulation were found to help reduce postsurgical complications, as was a multimodal approach to postoperative nausea, vomiting, and analgesia. Chewing gum, prokinetic agents, oral laxatives, and an early resumption to normal diet appear to aid faster return to normal bowel function. Further studies should compare anesthetic protocols, refine analgesia, and evaluate the importance of robot-assisted surgery and the need/timing for drains and catheters. Conclusions ERAS regimens are multidisciplinary, multimodal pathways that optimize postoperative recovery. Patient summary This review provides an overview of the use and key elements of Enhanced Recovery after Surgery programs, which are multimodal, multidisciplinary care pathways that aim to optimize postoperative recovery. Additional conclusions include identifying effective procedures within Enhanced Recovery after Surgery programs and defining needs for future clinical trials.

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Section: Evidence Synthesismentioning

confidence: 99%

“…Carbohydrate loading is a standard-of-care technique in ERAS programs that is safe in diabetic populations and can be given up to 2 h before surgery [14]. …”

Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

See 1 more Smart Citation

Enhanced Recovery after Urological Surgery: A Contemporary Systematic Review of Outcomes, Key Elements, and Research Needs

et al. 2016

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“…Рак предстательной железы на раннее восстановление функции кишечника) перед обширными вмешательствами. Как и остальные элементы fast track, они наиболее изучены в колорек-тальной хирургии [22,23]. Всем пациентам 2-й группы Диагностика и лечение опухолей мочеполовой системы.…”

Section: Discussionunclassified

Early recovery program in the radical surgical treatment of patients with prostate cancer: Experience of the specialized hospital

Berkut

Рева

Носов

2017

Clinical Nutrition ESPEN

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“…This differed from other studies, which had previously excluded those with known insulin resistance. 16 This was a non-randomised, blinded cohort study performed over 16 months and it included 34 cholecystectomy or thyroidectomy patients. All patients were given 800ml of CHO drink on the evening before surgery and 400ml 2-3 hours before surgery.…”

Section: Metabolic Implicationsmentioning

confidence: 99%

The role of carbohydrate drinks in preoperative nutrition for elective colorectal surgery

Jones

Badger

Hannon

2011

annals

137

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Traditionally, patients have fasted from midnight before elective surgery. This ensures an empty stomach, thereby helping protective laryngeal reflexes and reducing complications such as aspiration pneumonia. Enhanced recovery for elective colorectal surgery permits clear fluids and solids two and six hours respectively prior to surgery. Nutritional supplements pre-operatively are safe and alter the immune and catabolic response to surgery, enhancing post-operative recovery. [1][2][3][4] Fasting depletes glycogen stores, increasing the demand for amino acids. The endocrine response of insulin resistance to fasting is central to the catabolic surgical response, resulting in reduced insulin stimulated glucose uptake in skeletal muscle and adipose tissue, increased glucose release and hyperglycaemia. Hyperglycaemia is associated with more post-operative complications. Pre-operative carbohydrate (CHO) drinks may reduce insulin resistance by maintaining and improving whole-body protein balance and muscle function.This review aimed critically to appraise the evidence available regarding the use of pre-operative CHO supplements for elective colorectal surgery. MethodsA literature search was undertaken using PubMed, MEDLINE ® , Athens and Google Scholar. The following keywords were used: 'pre-operative', 'carbohydrate supplements', 'enhanced recovery' and 'colorectal surgery', singly or in combination. Twenty papers were found but only eleven were reviewed. Nine were excluded as they described studies involving nutritional supplements rather than carbohydrates specifically. The search was limited to English language papers but not restricted according to study type. To ensure an up-to-date literature search, it was restricted to the last ten years, with backward chaining of reference lists from retrieved papers. Discussion Safety of pre-operative nutritional supplementsEnhanced recovery has revolutionised colorectal surgery. Initially, concern was expressed regarding the safety of CHO supplements, which Yagci et al evaluated. 5 This was a randomised controlled trial (RCT) of 70 patients either undergoing a cholecystectomy or thyroidectomy. Pre-oper-

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Preoperative administration of oral carbohydrate-rich solutions: Comparison of glucometabolic responses and tolerability between patients with and without insulin resistance

Cited by 25 publications

References 19 publications

Enhanced Recovery after Urological Surgery: A Contemporary Systematic Review of Outcomes, Key Elements, and Research Needs

Enhanced Recovery after Urological Surgery: A Contemporary Systematic Review of Outcomes, Key Elements, and Research Needs

Early recovery program in the radical surgical treatment of patients with prostate cancer: Experience of the specialized hospital

The role of carbohydrate drinks in preoperative nutrition for elective colorectal surgery

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