PMID- 18294261
OWN - NLM
STAT- MEDLINE
DCOM- 20090324
LR  - 20101118
IS  - 1463-1318 (Electronic)
IS  - 1462-8910 (Linking)
VI  - 10
IP  - 9
DP  - 2008 Nov
TI  - Preoperative conditioning with oral carbohydrate loading and oral nutritional 
      supplements can be combined with mechanical bowel preparation prior to elective 
      colorectal resection.
PG  - 907-10
LID - 10.1111/j.1463-1318.2008.01499.x [doi]
AB  - OBJECTIVE: Preoperative conditioning with oral fluid and carbohydrate (CHO) 
      loading allows the patient to undergo surgery in the fed state and is associated 
      with reduced postoperative insulin resistance. Further benefit may accrue from 
      oral nutritional supplements (ONS) to counteract the fasting associated with 
      mechanical bowel preparation (MBP). In this study we assess the ability to 
      prescribe, dispense and have patients comply with a protocol combining 
      preoperative ONS and CHO/fluid loading during MBP. METHOD: One hundred and 
      forty-seven patients undergoing elective left colonic or rectal resection were 
      recruited to an Enhanced Recovery after Surgery (ERAS) programme. All patients 
      were prescribed MBP (2 sachets Picolax). On the daytime prior to surgery, 
      eligible patients were prescribed 2 x 200 ml of ONS (Fortijuice, Nutricia) and in 
      the evening 800 ml oral CHO/fluid loading (Preop(R), Nutricia,). Patients were 
      prescribed a further 400 ml of oral/CHO/fluid on the morning of surgery 2 h prior 
      to induction of anaesthesia. Protocol compliance was audited prospectively. 
      RESULTS: One hundred and forty-seven patients received MBP. Twenty-three patients 
      were ineligible for oral CHO/fluid loading [diabetes (n = 22), allergy to lemon 
      flavoured drinks (n = 1)]. Fourteen patients did not receive the preoperative CHO 
      drinks due to failure to prescribe (n = 8) or dispense (n = 6). One hundred and 
      ten patients were dispensed the combined ONS and CHO/fluid loading regimen, 
      compliance rates were 83% with ONS, 80% with CHO/fluid loading and 74% with both. 
      CONCLUSION: Approximately 74% of patients undergoing MBP can comply with 
      preoperative conditioning with ONS and CHO/fluid loading. Prescription and 
      dispensing requires close attention to detail.
FAU - Hendry, P O
AU  - Hendry PO
AD  - Department of Clinical and Surgical Sciences, Royal Infirmary of Edinburgh, 
      Edinburgh, UK. paul.hendry@ed.ac.uk
FAU - Balfour, A
AU  - Balfour A
FAU - Potter, M A
AU  - Potter MA
FAU - Mander, B J
AU  - Mander BJ
FAU - Bartolo, D C C
AU  - Bartolo DC
FAU - Anderson, D N
AU  - Anderson DN
FAU - Fearon, K C H
AU  - Fearon KC
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20080221
PL  - England
TA  - Colorectal Dis
JT  - Colorectal disease : the official journal of the Association of Coloproctology of 
      Great Britain and Ireland
JID - 100883611
RN  - 0 (Blood Glucose)
RN  - 0 (Cathartics)
RN  - 0 (Dietary Carbohydrates)
SB  - IM
MH  - Administration, Oral
MH  - Aged
MH  - Blood Glucose/metabolism
MH  - Cathartics
MH  - Clinical Protocols
MH  - Colon/surgery
MH  - Dietary Carbohydrates/*administration & dosage
MH  - *Dietary Supplements
MH  - *Digestive System Surgical Procedures
MH  - Female
MH  - Humans
MH  - Insulin Resistance/physiology
MH  - Male
MH  - Middle Aged
MH  - *Preoperative Care/methods
MH  - Rectum/surgery
MH  - Therapeutic Irrigation
EDAT- 2008/02/26 09:00
MHDA- 2009/03/25 09:00
CRDT- 2008/02/26 09:00
PHST- 2008/02/26 09:00 [pubmed]
PHST- 2009/03/25 09:00 [medline]
PHST- 2008/02/26 09:00 [entrez]
AID - CDI1499 [pii]
AID - 10.1111/j.1463-1318.2008.01499.x [doi]
PST - ppublish
SO  - Colorectal Dis. 2008 Nov;10(9):907-10. doi: 10.1111/j.1463-1318.2008.01499.x. 
      Epub 2008 Feb 21.