Barrett A Kielhorn1, Anthony J Senagore2, Theodor Asgeirsson3. 1. Metro Health - University of Michigan Health System, Wyoming, MI, USA; Clinical Associate Professor Michigan State University College of Osteopathic Medicine, Department of Osteopathic Surgical Specialties, USA. Electronic address: bkielhorn@gmail.com. 2. Professor, Vice Chair Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. 3. West Michigan Surgical Specialists LLC, Grand Rapids, MI, USA; Clinical Chief, Division of Colorectal Surgery Mercy Health St Mary's Hospital, Grand Rapids, MI, USA; Clinical Assistant Professor Michigan State University College of Osteopathic Medicine, Department of Osteopathic Surgical Specialties, USA; Clinical Assistant Professor Michigan State University College of Human Medicine, USA.
Abstract
BACKGROUND: Perioperative insulin resistance is associated with significant hyperglycemia-related morbidity in patients undergoing major surgery. We sought to assess the effect of preoperative loading with a low-dose maltodextrin/citrulline solution compared to a commercially available sports drink on glycemic levels in an established colorectal enhanced recovery program. METHODS: Retrospective analysis was undertaken of elective non-diabetic colectomies and enterectomies from January 2016-March 2017. Cohorts included simple (SIM) and complex carbohydrate (COM) groups. Statistical analysis was performed with linear and logarithmic regression. RESULTS: 83 patients were included (42 SIM, 41 COM). SIM group was older (61.7 vs 52.7 p = 0.012) Glycemic variability was less in the COM group (7.6% vs 21.4% P = 0.034). The frequency of hyperglycemia, postoperative complications, and length of stay trended higher in the SIM group. CONCLUSIONS: This retrospective analysis identifies significant improvement in the perioperative glycemic variability with preoperative low dose complex carbohydrate loading compared to simple carbohydrate loading in colorectal surgery patients.
BACKGROUND: Perioperative insulin resistance is associated with significant hyperglycemia-related morbidity in patients undergoing major surgery. We sought to assess the effect of preoperative loading with a low-dose maltodextrin/citrulline solution compared to a commercially available sports drink on glycemic levels in an established colorectal enhanced recovery program. METHODS: Retrospective analysis was undertaken of elective non-diabetic colectomies and enterectomies from January 2016-March 2017. Cohorts included simple (SIM) and complex carbohydrate (COM) groups. Statistical analysis was performed with linear and logarithmic regression. RESULTS: 83 patients were included (42 SIM, 41 COM). SIM group was older (61.7 vs 52.7 p = 0.012) Glycemic variability was less in the COM group (7.6% vs 21.4% P = 0.034). The frequency of hyperglycemia, postoperative complications, and length of stay trended higher in the SIM group. CONCLUSIONS: This retrospective analysis identifies significant improvement in the perioperative glycemic variability with preoperative low dose complex carbohydrate loading compared to simple carbohydrate loading in colorectal surgery patients.
Authors: Ellen Coeckelberghs; Kris Vanhaecht; Deborah Seys; Bianca Cox; Gabriele Bislenghi; Albert M Wolthuis; André D'Hoore Journal: Ann Surg Date: 2022-08-02 Impact factor: 13.787