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Shrinking preoperative fast time with maltodextrin and protein hydrolysate in gastrointestinal resections due to
Paula Alves Pexe-Machado1, Benedito Dario de Oliveira, Diana Borges Dock-Nascimento
1Department of Surgery, Julio Muller University Hospital, Federal University of Mato Grosso, Cuiabá, Brazil.
Objective:
Prolonged preoperative fasting increases postoperative hospital length of stay and current evidence recommends patients drink a carbohydrate-based liquid drink 2 h before surgery. The aim of this study was to investigate whether the addition of hydrolyzed protein to a carbohydrate-based drink would reduce both the inflammatory response and hospital length of stay.
Methods:
We evaluated 22 patients of both sexes, undergoing gastrointestinal resection due to cancer. Patients were randomized into two groups: control group (n = 12; 6-8 h fast) and the intervention group (n = 10; fasted to solids for 6 h; and given a beverage containing 11% pea protein hydrolysate and 89% carbohydrates (79% maltodextrin and 21% sucrose), 400 mL the night before and 200 mL 3 h before surgery. Blood samples were collected the morning before surgery and on postoperative day 2.
Results:
Overall mortality was 4.5% (one case, control group). The duration of postoperative hospital stay was twofold longer in the control group (P = 0.04). A significant increase of serum C-reactive protein/albumin ratio was observed in controls compared with the intervention group (P = 0.04).
Conclusion:
The abbreviation of preoperative fasting time to 3 h using a solution containing carbohydrates and hydrolyzed pea proteins reduces the acute-phase inflammatory response and decreases the postoperative length of stay in patients undergoing major surgery for a malignancy.
