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 .
Evaluation of the effects of a preoperative 2-hour fast with maltodextrine and glutamine on insulin resistance, acute-phase response, nitrogen balance, and serum glutathione after laparoscopic cholecystectomy: a controlled randomized trial.
BACKGROUND Prolonged preoperative fasting increases insulin resistance ( IR ) . The authors investigated whether an abbreviated preoperative fast with glutamine ( GLN ) plus a carbohydrate (CHO)-based beverage would improve the organic response after surgery . METHODS Forty-eight female patients ( 19 - 62 years ) were r and omized to either st and ard fasting ( control group ) or to fasting with 1 of 3 different beverages before video-cholecystectomy .  Beverages were consumed 8 hours ( 400 mL ; placebo group : water ; GLN group : water with 50 g maltodextrine plus 40 g GLN ; and CHO group : water with 50 g maltodextrine ) and 2 hours ( 200 mL ; placebo : water ; GLN : water with 25 g maltodextrine plus 10 g GLN ; and CHO : water with 25 g maltodextrine ) before anesthesia . Blood sample s were collected pre- and postoperatively . RESULTS The mean ( SEM ) postoperative homeostasis model assessment -insulin resistance was greater ( P < .05 ) in control patients ( 4.3 [ 1.3 ] ) than in the other groups ( placebo , 1.6 [ 0.3 ] ; CHO , 2.3 [ 0.4 ] ; and GLN , 1.5 [ 0.1 ] ) . Glutathione was significantly higher ( P < .01 ) in the GLN group than in both CHO and control groups . Interleukin-6 increased in all groups except the GLN group . The C-reactive protein/albumin ratio was higher ( P < .05 ) in controls than in CHO and GLN groups . The nitrogen balance was less negative in GLN ( -2.5 [ 0.8 ] gN ) than in both placebo ( -9.0 [ 2 ] gN ; P = .001 ) and control ( -6.6 [ 0.4 ] gN ; P = .04 ) groups . CONCLUSIONS Preoperative intake of a GLN-enriched CHO beverage appears to improve IR and antioxidant defenses and decreases the inflammatory response after video-cholecystectomy
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 .