BACKGROUND: The goal of the present study was to evaluate the effects of preoperative oral carbohydrate supplementation (OCH) on the postoperative metabolic stress response of patients undergoing elective abdominal surgery. METHODS: The study was designed as a controlled, prospective, cohort study including 38 patients treated with OCH (800 mL the day before surgery and 400 mL within 3 h before the induction of anesthesia) and 38 controls matched for surgical procedure. Fasting glucose, insulin, insulin resistance (HOMA-IR index), cortisol, and interleukin 6 (IL-6) were assessed before and after surgery (postoperative day (POD) 1, 2, and 3). RESULTS: The administration of OCH resulted in lower fasting glucose, HOMA-IR index, cortisol, and IL-6 on both POD 1 and POD 2. At multivariable regression analyses, the reduction of these parameters was independent of sex, age, body mass index, and major abdominal surgery. Particularly, models including OCH treatment explained 70, 63, and 66 % of the variance of the increase in IL-6 levels at POD 1, POD 2, and POD 3, respectively. The effect of OCH on changes in glucose, insulin resistance, and cortisol on POD 1 and POD 2 disappeared after the inclusion of IL-6 in the models. CONCLUSIONS: Treatment with OCH was associated with attenuation of the postoperative metabolic stress response. We hypothesize that modulation of the inflammatory response is one of the mechanisms involved.
BACKGROUND: The goal of the present study was to evaluate the effects of preoperative oral carbohydrate supplementation (OCH) on the postoperative metabolic stress response of patients undergoing elective abdominal surgery. METHODS: The study was designed as a controlled, prospective, cohort study including 38 patients treated with OCH (800 mL the day before surgery and 400 mL within 3 h before the induction of anesthesia) and 38 controls matched for surgical procedure. Fasting glucose, insulin, insulin resistance (HOMA-IR index), cortisol, and interleukin 6 (IL-6) were assessed before and after surgery (postoperative day (POD) 1, 2, and 3). RESULTS: The administration of OCH resulted in lower fasting glucose, HOMA-IR index, cortisol, and IL-6 on both POD 1 and POD 2. At multivariable regression analyses, the reduction of these parameters was independent of sex, age, body mass index, and major abdominal surgery. Particularly, models including OCH treatment explained 70, 63, and 66 % of the variance of the increase in IL-6 levels at POD 1, POD 2, and POD 3, respectively. The effect of OCH on changes in glucose, insulin resistance, and cortisol on POD 1 and POD 2 disappeared after the inclusion of IL-6 in the models. CONCLUSIONS: Treatment with OCH was associated with attenuation of the postoperative metabolic stress response. We hypothesize that modulation of the inflammatory response is one of the mechanisms involved.
Authors: Milan Kaska; Tat'ána Grosmanová; Eduard Havel; Radomír Hyspler; Zbynka Petrová; Miroslav Brtko; Pavel Bares; David Bares; Bronislava Schusterová; Lucie Pyszková; Vlasta Tosnerová; Martin Sluka Journal: Wien Klin Wochenschr Date: 2010-01 Impact factor: 1.704
Authors: Krishna K Varadhan; Keith R Neal; Cornelius H C Dejong; Kenneth C H Fearon; Olle Ljungqvist; Dileep N Lobo Journal: Clin Nutr Date: 2010-01-29 Impact factor: 7.324
Authors: S Mathur; L D Plank; J L McCall; P Shapkov; K McIlroy; L K Gillanders; A E H Merrie; J J Torrie; F Pugh; J B Koea; I P Bissett; B R Parry Journal: Br J Surg Date: 2010-04 Impact factor: 6.939
Authors: Margarita Ramos; Zain Khalpey; Stuart Lipsitz; Jill Steinberg; Maria Theresa Panizales; Michael Zinner; Selwyn O Rogers Journal: Ann Surg Date: 2008-10 Impact factor: 12.969
Authors: Andrew J Page; Aslam Ejaz; Gaya Spolverato; Tiffany Zavadsky; Michael C Grant; Daniel J Galante; Elizabeth C Wick; Matthew Weiss; Martin A Makary; Christopher L Wu; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2014-12-04 Impact factor: 3.452
Authors: Georgia Herbert; Rachel Perry; Henning Keinke Andersen; Charlotte Atkinson; Christopher Penfold; Stephen J Lewis; Andrew R Ness; Steven Thomas Journal: Cochrane Database Syst Rev Date: 2019-07-22
Authors: Georgia Herbert; Rachel Perry; Henning Keinke Andersen; Charlotte Atkinson; Christopher Penfold; Stephen J Lewis; Andrew R Ness; Steven Thomas Journal: Cochrane Database Syst Rev Date: 2018-10-24