JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (7)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Breuer, J.-P.
Right arrow Articles by Spies, C. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Breuer, J.-P.
Right arrow Articles by Spies, C. D.
Related Collections
Right arrow Cardiovascular
Right arrow Preoperative Evaluation

Anesth Analg 2006;103:1099-1108
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000237415.18715.1d


CARDIOVASCULAR ANESTHESIA

Preoperative Oral Carbohydrate Administration to ASA III-IV Patients Undergoing Elective Cardiac Surgery

Jan-P. Breuer, MD*, Vera von Dossow, MD*, Christian von Heymann, MD*, Markus Griesbach, MD*, Michael von Schickfus, Cand med*, Elise Mackh, Cand med*, Cornelia Hacker, Cand med*, Ulrike Elgeti, MD{dagger}, Wolfgang Konertz, MD{dagger}, Klaus-D. Wernecke, PhD{ddagger}, and Claudia D. Spies, MD*

From the *Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum; {dagger}Department of Cardiovascular Surgery; and {ddagger}Institute of Medical Statistics and Biometry, Campus Charité Mitte, CHARITÉ University Medicine Berlin, Berlin, Germany.

Address correspondence and reprint requests to Claudia Spies, MD, Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, CHARITÉ University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Address e-mail to claudia.spies{at}charite.de.

In this study we investigated the effects of preoperative oral carbohydrate administration on postoperative insulin resistance (PIR), gastric fluid volume, preoperative discomfort, and variables of organ dysfunction in ASA physical status III-IV patients undergoing elective cardiac surgery, including those with noninsulin-dependent Type-2 diabetes mellitus. Before surgery, 188 patients were randomized to receive a clear 12.5% carbohydrate drink (CHO), flavored water (placebo), or to fast overnight (control). CHO and placebo were treated in double-blind format and received 800 mL of the corresponding beverage in the evening and 400 mL 2 h before surgery. Patients were monitored from induction of general anesthesia until 24 h postoperatively. Exogenous insulin requirements to control blood glucose levels ≤10.0 mmol/L were used as a marker for PIR. Gastric fluid volume was measured by passive gastric reflux and preoperative discomfort using visual analog scales. Postoperative clinical and surgical data were recorded. Blood glucose levels and insulin requirements did not differ between groups. Patients receiving CHO and placebo were less thirsty compared with controls (P < 0.01 and P = 0.06, respectively). Ingested liquids did not cause increased gastric fluid volume or other adverse events. The CHO group required less intraoperative inotropic support after initiation of cardiopulmonary bypass weaning (P < 0.05). In conclusion, preoperative CHO administration before cardiac surgery does not affect PIR. Clear fluids reduce thirst and may be recommended as a safe procedure in ASA III-IV patients. Further research is indicated to investigate possible cardioprotective effects of preoperative CHO intake.




This article has been cited by other articles:


Home page
Arch SurgHome page
K. Lassen, M. Soop, J. Nygren, P. B. W. Cox, P. O. Hendry, C. Spies, M. F. von Meyenfeldt, K. C. H. Fearon, A. Revhaug, S. Norderval, et al.
Consensus Review of Optimal Perioperative Care in Colorectal Surgery: Enhanced Recovery After Surgery (ERAS) Group Recommendations
Arch Surg, October 1, 2009; 144(10): 961 - 969.
[Abstract] [Full Text] [PDF]




Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.