Shrinking preoperative fast time with maltodextrin and protein hydrolysate in gastrointestinal resections due to cancer

Nutrition. 2013 Jul-Aug;29(7-8):1054-9. doi: 10.1016/j.nut.2013.02.003.

Abstract

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • C-Reactive Protein / metabolism
  • Fasting*
  • Female
  • Gastrointestinal Tract / surgery
  • Humans
  • Insulin / blood
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasms / surgery
  • Polysaccharides / administration & dosage*
  • Postoperative Period
  • Preoperative Care / methods*
  • Protein Hydrolysates / administration & dosage*
  • Serum Albumin / analysis
  • Single-Blind Method

Substances

  • Blood Glucose
  • Insulin
  • Polysaccharides
  • Protein Hydrolysates
  • Serum Albumin
  • maltodextrin
  • C-Reactive Protein