The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .
Labeled acetate to assess intestinal absorption in critically ill patients
Objective To compare the absorption of  carbon-13 ( C ) acetate – enriched nutrients with D-xylose absorption . Design Prospect i ve cohort observational study . Setting Surgical intensive care unit of a university hospital . Patients A total of 24 critically ill patients requiring enteral nutritional support . InterventionThe patients were divided into three groups according to the route of C acetate administration : 1 ) gastric , 2 ) jejunal , and 3 ) intravenous . D-xylose was administered via the same route as enteral nutrition . Measurements and Main Results C acetate absorption and oxidation were reflected by pulmonary CO2 excretion . Breath CO2 isotopic enrichment was measured by mass spectrometry . C acetate absorption was rapid , and D-xylose absorption was depressed in all three groups , compared with the normal values ( p < .0001 ) . Breath CO2 isotopic enrichment was similar after intravenous and jejunal administration but slightly delayed during the first 240 mins after gastric administration ( p < .01 ) . Enteral feeding was well tolerated : mean energy delivery amounted to 77 % , 88 % , and 86 % of measured resting energy expenditure on days 1–3 . Conclusions Gastric and jejunal C acetate are rapidly absorbed in critically ill surgical patients requiring enteral nutrition , contrasting with a depressed or delayed D-xylose absorption . CO2 recovery kinetics was similar after jejunal or intravenous C acetate and slightly depressed after gastric administration . Further studies are required to determine the value of labeled nutrients to assess gastric emptying and intestinal absorption
The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .