this guideline reflects the recommendations of the group of specialists of the Brazilian College of Surgeons , the Brazilian Society of Parenteral and Enteral Nutrition and the ACERTO Project for nutritional interventions in the perioperative period of Elective General Surgery .
The prescription of these recommendations can accelerate the postoperative recovery of patients su bmi tted to elective general surgery , with decrease in morbidity , length of stay and rehospitalization , and consequently , of costs
OBJECTIVE to present recommendations based on the ACERTO Project ( Acceleration of Total Post-Operative Recovery ) and supported by evidence related to perioperative nutritional care in General Surgery elective procedures .
Effects of preoperative feeding with a whey protein plus carbohydrate drink on the acute phase response and insulin resistance. A randomized trial
Background Prolonged preoperative fasting increases insulin resistance and current evidence recommends carbohydrate ( CHO ) drinks 2 hours before surgery . Our hypothesis is that the addition of whey protein to a CHO-based drink not only reduces the inflammatory response but also diminish insulin resistance . Methods Seventeen patients scheduled to cholecystectomy or inguinal herniorraphy were r and omized and given 474 ml and 237 ml of water ( CO group ) or a drink containing CHO and milk whey protein ( CHO-P group ) respectively , 6 and 3 hours before operation . Blood sample s were collected before surgery and 24 hours afterwards for biochemical assays . The endpoints of the study were the insulin resistance ( IR ) , the prognostic inflammatory and nutritional index ( PINI ) and the C-reactive protein (CRP)/albumin ratio . A 5 % level for significance was established . Results There were no anesthetic or postoperative complications . The post-operative IR was lower in the CHO-P group when compared with the CO group ( 2.75 ± 0.72 vs 5.74 ± 1.16 ; p = 0.03 ) . There was no difference between the two groups in relation to the PINI . The CHO-P group showed a decrease in the both CRP elevation and CRP/albumin ratio ( p < 0.05 ) . The proportion of patients who showed CRP/albumin ratio considered normal was significantly greater ( p < 0.05 ) in the CHO-P group ( 87.5 % ) than in the CO group ( 33.3 % ) . Conclusions Shortening the pre-operative fasting using CHO and whey protein is safe and reduces insulin resistance and postoperative acute phase response in elective moderate operations . Trial registration Clinical Trail.gov
this guideline reflects the recommendations of the group of specialists of the Brazilian College of Surgeons , the Brazilian Society of Parenteral and Enteral Nutrition and the ACERTO Project for nutritional interventions in the perioperative period of Elective General Surgery .
The prescription of these recommendations can accelerate the postoperative recovery of patients su bmi tted to elective general surgery , with decrease in morbidity , length of stay and rehospitalization , and consequently , of costs
OBJECTIVE to present recommendations based on the ACERTO Project ( Acceleration of Total Post-Operative Recovery ) and supported by evidence related to perioperative nutritional care in General Surgery elective procedures .