Preoperative carbohydrate loading reduces length of stay after major elective, non-cardiac surgery when compared to fasting: a systematic review and meta-analysis.

IF 3.9 2区综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES

Scientific Reports Pub Date : 2025-05-31 DOI:10.1038/s41598-025-00767-z

Anna Réka Sebestyén, Caner Turan, Ambrus Szemere, Marcell Virág, Klementina Ocskay, Fanni Dembrovszky, László Szabó, Péter Hegyi, Marie Anne Engh, Zsolt Molnár

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Abstract

Preoperative fasting is a worldwide routine even though the most recent Enhanced Recovery After Surgery (ERAS) Guidelines recommend preoperative carbohydrate loading instead of fasting, but with low quality of evidence. Our aim was to compare the effects of preoperative carbohydrate loading to fasting and placebo in patients undergoing elective major non-cardiac surgery under general anaesthesia. Our systematic search was conducted on 15th of October 2021 in five databases, Medline, Embase, Central, Web of Science and Scopus, and updated on November 12th, 2024. We included randomized controlled trials that compared the carbohydrate loading (CHO-group) with fasting or with placebo. Main outcomes were length of hospital stay (LOS), postoperative glucose levels on postoperative, postoperative insulin levels, and C-reactive protein (CRP) levels. Our search revealed 44 eligible articles for data extraction. LOS was shorter in the CHO group as compared to the No-CHO group (MD: - 0.56 [95% CI: - 1.10, - 0.02]). There were no clinically significant differences between the CHO and No-CHO groups regarding the postoperative glucose, insulin and CRP levels. This meta-analysis found that preoperative CHO-loading as compared to preoperative fasting or placebo shortened the length of hospital stay in patients undergoing major elective, non-cardiac surgery. Although several details are still to be unveiled, these data provide further support that preoperative carbohydrate loading could be beneficial in this patient population.

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与禁食相比，术前碳水化合物负荷减少了重大选择性非心脏手术后的住院时间：一项系统回顾和荟萃分析。

术前禁食是世界范围内的常规做法，尽管最新的手术后增强恢复（ERAS）指南推荐术前碳水化合物负荷而不是禁食，但证据质量较低。我们的目的是比较在全麻下接受选择性非心脏大手术的患者术前碳水化合物负荷与禁食和安慰剂的影响。我们的系统检索于2021年10月15日在Medline、Embase、Central、Web of Science和Scopus五个数据库中进行，并于2024年11月12日更新。我们纳入了将碳水化合物负荷（cho组）与禁食组或安慰剂组进行比较的随机对照试验。主要结局是住院时间（LOS）、术后血糖水平、术后胰岛素水平和c反应蛋白（CRP）水平。我们的搜索显示了44篇符合数据提取条件的文章。CHO组的LOS较No-CHO组短（MD: - 0.56 [95% CI: - 1.10, - 0.02]）。CHO组与no -CHO组术后血糖、胰岛素、CRP水平无显著差异。这项荟萃分析发现，与术前禁食或安慰剂相比，术前cho负荷缩短了接受重大非心脏手术的患者的住院时间。尽管一些细节仍有待公布，但这些数据进一步支持术前碳水化合物负荷可能对这类患者有益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Scientific Reports Natural Science Disciplines-

CiteScore

7.50

自引率

4.30%

发文量

19567

审稿时长

3.9 months

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