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The benefits of a low dose complex carbohydrate/citrulline electrolyte solution for preoperative carbohydrate
Barrett A Kielhorn1, Anthony J Senagore2, Theodor Asgeirsson3
1Metro 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.
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.
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