Objective:To evaluate the change in respiratory function and functional capacity according to the type of preoperative fasting.Methods:Randomized prospective clinical trial, with 92 female patients undergoing cholecystectomy by laparotomy with conventional or 2 hours shortened fasting. The variables measured were the peak expiratory flow, forced expiratory volume in the first second, forced vital capacity, dominant handgrip strength, and non-dominant handgrip strength. Evaluations were performed 2 hours before induction of anesthesia and 24 hours after the operation.Results:The two groups were similar in preoperative evaluations regarding demographic and clinical characteristics, as well as for all variables. However, postoperatively the group with shortened fasting had higher values than the group with conventional fasting for lung function tests peak expiratory flow (128.7±62.5 versus 115.7±59.9; p=0.040), forced expiratory volume in the first second (1.5±0.6 versus 1.2±0.5; p=0.040), forced vital capacity (2.3±1.1 versus 1.8±0.9; p=0.021), and for muscle function tests dominant handgrip strength (24.9±6.8 versus 18.4±7.7; p=0.001) and non-dominant handgrip strength (22.9±6.3 versus 17.0±7.8; p=0.0002). In the intragroup evaluation, there was a decrease in preoperative compared with postoperative values, except for dominant handgrip strength (25.2±6.7 versus 24.9±6.8; p=0.692), in the shortened fasting group.Conclusion:Abbreviation of preoperative fasting time with ingestion of maltodextrin solution is beneficial to pulmonary function and preserves dominant handgrip strength.
Introduction: The ability of selenium to reduce free radicals, associated with its performance as an essential cofactor for glutathione peroxidase, confers a potential role for patients in the intensive care unit. The aim of this study was to evaluate the plasma levels of selenium and glutathione peroxidase at admission and for the period of 7 days of evolution in hospitalized patients. Methods: Observational study with adult patients (n = 22) admitted to the intensive care unit. Three blood samples were taken, on days 1, 3 and 7, to assess selenium, and two for glutathione peroxidase, on days 1 and 7. There was no type of intervention. Results: Selenium levels at admission were
below the reference values in half of the patients. When stratifying patients (n = 22) according to the risk of infectious and inflammatory complications (C-reactive protein / albumin ratio), patients classified as high risk had selenium dosage at admission below those of moderate risk (p = 0.032). Among patients with complete follow-up (all dosages were performed), 66.7% were at high risk and among them 75% had selenium below the reference values and below the moderate risk group (p = 0.014). Glutathione peroxidase dosages were normal in all patients, regardless of classification. Conclusion: Approximately 50% of critically ill patients were admitted to the
intensive care unit with selenium below the reference values. On admission and progression to the seventh day, patients classified as high risk had selenium dosage below the reference value and below that of patients at moderate risk.
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