Enhanced muscle strength with carbohydrate supplement two hours before open cholecystectomy: a randomized, double-blind study

Gava, M.G.; Castro-Barcellos, Heloisa Michelon; Caporossi, Cervantes; Aguilar-Nascimento, José Eduardo de

doi:10.1590/0100-69912016001011

Cited by 10 publications

(8 citation statements)

References 28 publications

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“…A total of 63 patients were randomized. Time to rst atus did not differ between groups (median [95% CI], 40 hours [30,50] in control group vs. 43 hours [37,48] in carbohydrate group, hazard ratio [95% CI], 1.24 [0.74, 2.07], P = 0.411). Both pre-and postoperative subjective feelings of discomfort were all signi cantly lower in carbohydrate group than in control group (median difference from − 50 to 0; all P < 0.05).…”

Section: Resultsmentioning

confidence: 99%

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Preoperative carbohydrate loading in diabetic patients undergoing gastrointestinal surgery: A pilot randomized trial

Xue

Lin

Liang

et al. 2020

Preprint

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BackgroundPreoperative carbohydrate loading is used to improve patients’ comfort and recovery, but evidence remains limited in diabetic patients. We tested the feasibility of a preoperative carbohydrate drink with supplemental insulin in diabetic patients for gastrointestinal surgery.MethodsAdult patients with type 2 diabetes mellitus who were scheduled for major gastrointestinal surgery were randomized to carbohydrate group (carbohydrate drink with supplement insulin selectively) or control group (clinical routine management). The primary outcome was the time to first flatus after surgery. Among secondary outcomes, subjective feelings of thirsty, hunger and fatigue were assessed with the Visual Analogue Scale (scores range from 0 to 100, where 0 indicate no discomfort and 100 the most severe discomfort) before and after surgery.ResultsA total of 63 patients were randomized. Time to first flatus did not differ between groups (median [95% CI], 40 hours [30, 50] in control group vs. 43 hours [37, 48] in carbohydrate group, hazard ratio [95% CI], 1.24 [0.74, 2.07], P = 0.411). Both pre- and postoperative subjective feelings of discomfort were all significantly lower in carbohydrate group than in control group (median difference from − 50 to 0; all P < 0.05). Patients with carbohydrate drink developed less intraoperative hypotension (40.6% [13/30] vs. 16.1% [5/31], P = 0.031) and postoperative nausea and vomiting within 24 hours (31.3% [10/32] vs. 9.7% [3/31], P = 0.034).ConclusionIn diabetic patients undergoing gastrointestinal surgery, preoperative carbohydrate loading with supplemental insulin selectively did not affect gastrointestinal recovery; but it improved perioperative comfort, and reduced intraoperative hypotension and postoperative nausea and vomiting.Trial RegistrationClinicalTrial.gov, NCT03204344; Registered July 2, 2017, https://clinicaltrials.gov/ct2/show/NCT03204344.

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Section: Resultsmentioning

confidence: 99%

“…We also found time to rst ambulation tended to be earlier in patients with carbohydrate drinks. Other studies reported that preoperative carbohydrate loading was helpful in preserving muscle strength which might promote early ambulation after surgery (Liu, et al, 2018;Gava, et al, 2016;Lidder, et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Preoperative carbohydrate loading in diabetic patients undergoing gastrointestinal surgery: A pilot randomized trial

Xue

Lin

Liang

et al. 2020

Preprint

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“…The ACERTO protocol aims to reduce costs and unfavorable outcomes both in private hospitals and those in the public network, and to improve results even in medium-sized operations. Several studies have reported benefits in cholecystectomy 4,6 , but no investigation has been done in operations to treat abdominal wall hernias.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of hernioplasties before and after the implementation of the ACERTO project

Nascimento

Salomão

Ribeiro

et al. 2020

Rev. Col. Bras. Cir.

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Objective: to compare hospital costs and clinical outcomes in inguinal and incisional hernioplasty before and after implementation of the ACERTO project in a university hospital. Methods: retrospective study of 492 patients undergoing either inguinal hernioplasty (n=315) or incisional hernioplasty (n=177). The investigation involved two phases: between January 2002 and December 2005, encompassing cases admitted before the implementation of the ACERTO protocol (PRE-ACERTO period), and the other phase, with cases operated between January 2006 and December 2011, after the implementation of the protocol (ACERTO period). The main outcome variable was the comparison of the mean hospital costs between the two periods. As secondary endpoints, we analyzed the length of stay, the surgical site infection rate and mortality. We used the cost method suggested by Public Sector Cost Information System. Results: surgical site infection was higher (p = 0.039) in the first phase of the study for both inguinal hernia operations (2 (1.6%) versus 0 (0%) cases) and incisional hernioplasty (5 (7.6%) versus 3 (2.7%) cases). The length of stay decreased one day after the implementation of the ACERTO protocol (p=0.005). There was a reduction in costs per patient from R$ 4,328.58 per patient in the first phase to R$ 2,885.72 in the second phase (66.7% reduction). Conclusion: there was a reduction in infectious morbidity, length of stay and hospital costs in hernioplasty after the implementation of the ACERTO protocol.

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“…( 20 ) With this technique we can assess, within days or hours, functional and nutritional alterations and the efficacy of the nutritional therapy prescribed. ( 21 )…”

Section: Introductionmentioning

confidence: 99%

Effects of overnight fasting on handgrip strength in inpatients

Correa-Arruda¹,

Vaez²,

Aguilar-Nascimento³

et al. 2018

Einstein (São Paulo)

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Objective:To investigate the effects of overnight fasting on handgrip strength of adult inpatients.Methods:A prospective clinical study enrolling 221 adult patients. The endpoints were handgrip strength obtained by dynamometry in three time points (morning after an overnight fasting, after breakfast and after lunch) and the cumulative handgrip strength (mean of handgrip strength after breakfast and lunch) in the same day. The mean of three handgrip strength measures was considered to represent each time point. A cut-off for the mean overnight fasting handgrip strength at the 50th percentile (35.5kg for males and 27.7kg for females) was used for comparisons. We registered the age, sex, current and usual weight (kg), weight loss (kg), diagnosis of cancer, nutritional status, elderly frequency, digestive tract symptoms, type of oral diet, and the amount of dinner ingested the night before handgrip strength (zero intake, until 50%, <100% and 100%).Results:Handgrip strength evaluated after an overnight fasting (31.2±8.7kg) was lesser when compared with handgrip strength after breakfast (31.6±8.8kg; p=0.01), and with cumulative handgrip strength (31.7±8.8kg; p<0.001). Handgrip strength was greater in patients who ingested 100% (33.2±9.1kg versus 30.4±8.4kg; p=0.03) and above 50% of dinner (32.1±8.4kg versus 28.6±8.8kg; p=0.006). Multivariate analysis showed that ingesting below 50% of dinner, severe malnutrition, and elderly were independent factors for handgrip strength reduction after overnight fasting.Conclusion:The muscular function was impaired after an overnight fasting of adult patients hospitalized for medical treatment, especially for those with low ingestion, malnourished and elderly.

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Enhanced muscle strength with carbohydrate supplement two hours before open cholecystectomy: a randomized, double-blind study

Abstract: the abbreviation of preoperative fasting to two hours with drink containing carbohydrate improves muscle function in the perioperative period.

Cited by 10 publications

References 28 publications

Preoperative carbohydrate loading in diabetic patients undergoing gastrointestinal surgery: A pilot randomized trial

Preoperative carbohydrate loading in diabetic patients undergoing gastrointestinal surgery: A pilot randomized trial

Cost-effectiveness analysis of hernioplasties before and after the implementation of the ACERTO project

Effects of overnight fasting on handgrip strength in inpatients

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