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A meta-analysis of randomised controlled trials on preoperative oral carbohydrate treatment in elective surgery
Örebro University Hospital. Institution for Surgery & Molecular Medicine, Karolinska Institute, Stockholm, Sweden.ORCID iD: 0000-0003-2636-4745
2013 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 32, no 1, p. 34-44Article in journal (Refereed) Published
Abstract [en]

BACKGROUND & AIMS: Whilst preoperative carbohydrate treatment (PCT) results in beneficial physiological effects, the effects on postoperative clinical outcomes remain unclear and were studied in this meta-analysis.

METHODS: Prospective studies that randomised adult non-diabetic patients to either PCT (≥50 g oral carbohydrates 2-4 h pre-anaesthesia) or control (fasted/placebo) were included. The primary outcome was length of hospital stay. Secondary outcomes included development of postoperative insulin resistance, complications, nausea and vomiting. Methodological quality was assessed using GRADEpro(®) software.

RESULTS: Twenty-one randomised studies of 1685 patients (733 PCT: 952 control) were included. No overall difference in length of stay was noted for analysis of all studies or subgroups of patients undergoing surgery with an expected hospital stay ≤2 days or orthopaedic procedures. However, patients undergoing major abdominal surgery following PCT had reduced length of stay [mean difference, 95% confidence interval: -1.08 (-1.87 to -0.29); I(2) = 60%, p = 0.007]. PCT reduced postoperative insulin resistance with no effects on in-hospital complications over control (risk ratio, 95% confidence interval, 0.88 (0.50-1.53), I(2) = 41%; p = 0.640). There was significant heterogeneity amongst studies and, therefore, quality of evidence was low to moderate.

CONCLUSIONS: PCT may be associated with reduced length of stay in patients undergoing major abdominal surgery, however, the included studies were of low to moderate quality.

Place, publisher, year, edition, pages
2013. Vol. 32, no 1, p. 34-44
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-27238DOI: 10.1016/j.clnu.2012.10.011ISI: 000315251600005PubMedID: 23200124OAI: oai:DiVA.org:oru-27238DiVA, id: diva2:602499
Available from: 2013-02-01 Created: 2013-02-01 Last updated: 2018-09-13Bibliographically approved

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Ljungqvist, Olle

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CiteExportLink to record
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