Preoperative infusion of amino acids prevents postoperative hypothermia

Selldén, Eva; Bränström, Robert; Brundin, T.

doi:10.1093/bja/76.2.227

Cited by 66 publications

(41 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In previous studies [3,5], the thermogenesis effect of intraoperative amino acid infusion has been obvious from about 2 h after the induction of anesthesia, just as in our results, but few studies have investigated the relationship between the doses of amino acids administration during operations and the thermogenesis effect. This study showed that from 100 and 120 min after skin incision to 6 h after the operation, medium and high doses of amino acid infusion had the same effect in preventing hypothermia, while low doses of amino acids had no such effect, as Sahin et al [9] found before.…”

Section: Discussionsupporting

confidence: 75%

“…Intraoperative amino acid infusion exerts a marked thermogenic effect with enhanced oxygen consumption [2,3,4,5], mainly in the extra-splanchnic tissues, and significantly attenuates the decrease in core temperature during general anesthesia [6,7]. …”

Section: Introductionmentioning

confidence: 99%

“…According to the basal metabolic rate, earlier studies administered amino acids at a rate of 240 kJ·h –1 (3–4 kJ·kg –1 ·h –1 ) and revealed a significant favorable effect of amino acids on intraoperative hypothermia in hu- mans [2,3,4,5,8], while Sahin et al [9], who used the low- er infusion rate (100 kJ·h –1 ), had negative results. According to the daily fuel requirement of mongrel dogs (300 kJ·kg –1 ·day –1 ) [10], we compared the effects of low, medium, and high doses of intraoperative amino acid infusion (0, 6, 12, and 24 kJ·kg –1 ·h –1 ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Metabolic Effects of Intraoperative Amino Acid Infusion in Mongrel Dogs

Lin

Wang³

et al. 2012

Ann Nutr Metab

View full text Add to dashboard Cite

Background: Intraoperative amino acid infusion can attenuate the decrease in core temperature, but the metabolic effects are uncertain. Methods: Thirty-six healthy mongrel dogs undergoing ileectomy under general anesthesia were infused intraoperatively with normal saline or 18 compound amino acids at 6, 12, and 24 kJ·kg^–1·h^–1 (NS, 6-, 12-, and 24-kJ groups) and studied until 24 h after the operation. Blood glucose, plasma insulin, free fatty acids, and triglyceride concentrations were determined at 7 defined time points. Muscle aminograms, urinary urea, and 3-methylhistidine excretions were measured before and after the operation. Results: Blood glucose and plasma insulin increased amino acid dose dependently during the operation and in the early period after the operation. Free fatty acids were significantly lower in the 12- and 24-kJ groups compared with the NS group at the end of the operation. The negative nitrogen balance was alleviated dose dependently in the amino acid groups on operation day. The urinary 3-methylhistidine decreased significantly during the first 24 h after the operation in the 24-kJ group, while it increased in the other groups with the largest increase in the NS group. Basic, branched-chain, and aromatic amino acids in the vastus lateralis muscle increased dose dependently at the end of the operation in the amino acid groups. Conclusion: Intraoperative amino acid infusion has the dose-dependent effects of increasing blood glucose, inhibiting fat mobilization and muscle protein breakdown.

show abstract

Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Metabolic Effects of Intraoperative Amino Acid Infusion in Mongrel Dogs

Lin

Wang³

et al. 2012

Ann Nutr Metab

View full text Add to dashboard Cite

show abstract

“…Here, the most frequently used nutrients are amino acids. It was noted that amino acid solution administered 1–2 h before general anesthesia induction and at the first hour of the maintenance of anesthesia as 240 kj/h has been suggested to increase heat accumulation and prevent hypothermia by delaying heat generation stimulation and to increase vasoconstriction threshold, and that postoperative shivering were not observed [18–21]. In addition, when amino acid solution was administered to patients under spinal anesthesia, central temperature increased before performing spinal anesthesia and the decrease in central temperature reduced after performing it [22,23].…”

Section: Discussionmentioning

confidence: 99%

Effects of preoperative oral carbohydrate solution intake on thermoregulation

et al. 2013

View full text Add to dashboard Cite

BackgroundWe aimed to investigate the oral carbohydrate solution administered preoperatively on thermoregulation.Material/MethodsThe study included 40 female patients under general anesthesia. Patients were randomly divided into 2 groups: Group CONT (stopped oral implementation 8 h before the operation) and Group CHO (800ml oral carbohydrate fluid 8 h before the operation and 400ml oral carbohydrate fluid 2 h before the operation). Patients were monitored as standard and temperature probes were placed. Temperatures were recorded immediately before anesthetics induction, 5 min after the anesthetics induction, and in the post-anesthesia care unit (PACU) every 10 min. Mean skin temperature (Tsk), mean body temperature (Tb), and vasoconstriction threshold were estimated.ResultsIn general, we observed a decrease in tympanic temperature and Tb following anesthetic administration in groups, and increase in Tsk, and an increase in all 3 of these levels in the recovery unit. Tympanic temperature was significantly higher at 25, 55, 65, and 95 min after induction in Group CONT compared to Group CHO (p<0.05). Tsk was found to be lower in Group CONT compared to Group CHO in almost all periods. In PACU, it was found that the tympanic temperature was higher in Group CONT compared to Group CHO at 60 min (p<0.05). Postoperative shivering score was found to be significantly higher in Group C (p<0.01). Vasoconstriction threshold was higher in Group CONT than Group CHO.ConclusionsOral carbohydrate solution administered was established to have effects thought to be negative on tympanic temperature, vasoconstriction, and vasoconstriction threshold.

show abstract

“…Selldén, one of authors of this article, reported that infusion of amino acids before or during general anesthesia is useful to prevent hypothermia [27]. In addition, amino acids infusion was demonstrated to shorten hospital stay [2].…”

Section: Prevention Of Hypothermiamentioning

confidence: 94%

Amino Acids during Perioperative Period

Yokoyama¹,

Yamaoka²,

Hitosugi³

et al. 2017

OJAnes

View full text Add to dashboard Cite

During anesthesia, thermoregulation is impaired and hypothermia will frequently occur in most patients. Hypothermia affects immunologic activity, bleeding tendency and the recovery from anesthesia. Therefore, it may prolong hospital stay, and increase morbidity, e.g. surgical site infections, cardiac events and multiple organ dysfunctions in trauma. External warming is often used to prevent hypothermia. However, infusion of amino acids is also valuable to prevent hypothermia due to their enhanced thermogenic action under anesthesia. During surgery, amino acids administration would maintain the body homeostasis, and counteract the disadvantageous fasting metabolism. Postoperatively, amino acids may be advantageous for the healing of the surgical wound. Thus, appropriate nutritional management, including glucose, during the perioperative period would prevent catabolism, frequently occurring after surgery. Protocols like ERAS (Enhanced Recovery After Surgery) are proposed for quick recovery after surgery. ERAS protocol recommends preoperative carbohydrate and early enteral nutrition, but does not include infusion of amino acids during the perioperative period. During prolonged surgery, patients clearly need good nutritional support. In this article, we intend to describe the problems of hypothermia briefly, and explain the mechanism of amino acids in hypothermia prevention. In addition, we address some evidences of nutritional management during the perioperative period.

show abstract

Preoperative infusion of amino acids prevents postoperative hypothermia

Cited by 66 publications

References 0 publications

Metabolic Effects of Intraoperative Amino Acid Infusion in Mongrel Dogs

Metabolic Effects of Intraoperative Amino Acid Infusion in Mongrel Dogs

Effects of preoperative oral carbohydrate solution intake on thermoregulation

Amino Acids during Perioperative Period

Contact Info

Product

Resources

About