The benefits of a low dose complex carbohydrate/citrulline electrolyte solution for preoperative carbohydrate loading: Focus on glycemic variability.

Autor: Kielhorn BA; 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., Senagore AJ; Professor, Vice Chair Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA., Asgeirsson T; 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.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2018 Mar; Vol. 215 (3), pp. 373-376. Date of Electronic Publication: 2017 Nov 08.
DOI: 10.1016/j.amjsurg.2017.10.029
Abstrakt: 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.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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