Conventional Fasting Versus Lipid/Carbohydrate Infusion for Coronary Bypass Patients

Study Overview
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Brief Summary
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Comparative study between conventional fasting versus overnight infusion of lipid or carbohydrate on free fatty acids and insulin in obese patients undergoing elective first time on-pump coronary artery bypass grafting.

Detailed Description
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Obese patients scheduled for bypass surgery randomly assigned to three groups: Group I (Glucose-group): patients received 500 cc of glucose 10% containing 50 g of glucose and providing patients with 200 Kcal with an osmolarity of 556 mosm/L. Group II (Lipid-group): patients received 100 cc of lipid solution (soybean 30%, medium chain triglycerides 30%,olive oil 25%,fish oil 15% and 20 mg vitamine E) containing 20 g lipid and provides patients with 200 Kcal with an osmolarity of 380 mosm/L. Group III (Control-group): patients fasted overnight from 11 pm till 9 am except for clear fluids which were allowed till 5 am.

Official Title
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Comparative Study Between Conventional Fasting Versus Overnight Infusion of Lipid or Carbohydrate on Free Fatty Acid and Insulin in Obese Patients Undergoing Elective First Time On-pump Coronary Artery Bypass Grafting

Conditions
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Metabolism Disorder

Intervention / Treatment
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* Dietary Supplement: G group
* Dietary Supplement: group L
* Dietary Supplement: Group C


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients (> 18 years) with American Society of Anesthesia (ASA) class II-III, BMI 30-40, and New York Heart Association (NYHA) functional capacities I-II, undergoing elective on-pump coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB). All patients were type 1a World Health Organisation (WHO)/Fredrickson classification of primary hyperlipidemias. Exclusion Criteria: Patients with diabetes mellitus Patients on fibrates Patients type 1,2b,3,4 and 5 WHO/Fredrickson classification of primary hyperperlipidemias Patients with history of allergic reactions to fish, egg yolk containing foods peanut or soy products Patients with carbohydrate or fat intolerance

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Glucose group (G group)<br>patients received 500 cc of glucose 10% that containing 50 g of glucose and provides patients with 200 Kcal with 556 mosmoles/L. | Dietary Supplement: G group<br>* patients received 500 cc of glucose 10% containing 50 g of glucose proving patients with 200 Kcal with 556 mosmoles/L<br>|
| Experimental: Lipid Group (L group)<br>patients received 100 cc of lipid solution (soybean 30%, medium chain triglycerides 30%,olive oil 25%,fish oil 15% and 20 mg vitamine E) containing 20 g lipid and provides patients with 200 Kcal with osmolarity of 380 mosmoles /L. | Dietary Supplement: group L<br>* patients received 100 cc of lipid solution (soybean 30%, medium chain triglycerides 30%,olive oil 25%,fish oil 15% and 20 mg vitamine E) containing 20 g lipid which provided patients with 200 Kcal with osmolarity of 380 mosmoles /L. with a flow rate of infusion of 12.5 cc per hour<br>|
| Experimental: Control Group (C group)<br>patients was fasting overnight from 11 pm till 9 am except for clear fluids that was allowed till 5 am. | Dietary Supplement: Group C<br>* Over night fasting with no supplementation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The change in free fatty acids levels and insulin blood levels before and after the infusion of study solution |  | Over an infusion period of 10 hours preoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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perioperative fasting, free fatty acids, coronary bypass grfting