Preoperative Liquid Carbohydrate Loading in Plastic Surgery Patients During an IV Fluid Shortage: A Matched...

Hurricane Helene introduced significant disruptions in the intravenous (IV) fluid supply chain. Ambulatory surgery centers were particularly affected, necessitating fluid conservation without compromising safety. Preoperative liquid carbohydrate loading is a promising intervention to improve outcomes while reducing IV fluid use. This study evaluated the effectiveness of liquid carbohydrate protocols during periods of resource strain.

Patients from ambulatory surgery centers were divided into a liquid carbohydrate protocol group (LPG, n = 58) after Hurricane Helene and a control group (CG, n = 58) before the disaster. The LPG consumed 355 mL of Gatorade and 355 mL of water 3 hours preoperatively, whereas the CG followed standard fasting protocols. Outcomes of interest included intraoperative IV fluid use, postoperative antiemetic use, postanesthesia care unit stay length, surgical delays, and protocol adherence.

IV fluid intake was 1460 mL in the LPG and 1820 mL in the CG (P = 0.041). One patient in the LPG required an antiemetic versus 3 in the CG (P = 0.612). The mean postanesthesia care unit recovery time was 103 and 100 minutes in the LPG and CG, respectively (P = 0.721). There was 1 surgical delay in the CG and 6 in the LPG (P = 0.051). The compliance rate in the LPG was 58.6% and that in the CG was 98.3% (P < 0.001).

Consuming liquid carbohydrates preoperatively reduced intraoperative IV fluid use, but did not improve nausea or recovery time. Liquid protocol patients were less compliant and had more surgical start delays. These findings suggest that liquid carbohydrate protocols may not be feasible during fluid shortages.