PMID- 27038614
OWN - NLM
STAT- MEDLINE
DCOM- 20161020
LR  - 20181113
IS  - 1475-2891 (Electronic)
IS  - 1475-2891 (Linking)
VI  - 15
DP  - 2016 Apr 2
TI  - Multimodal perioperative care plus immunonutrition versus traditional care in 
      total hip arthroplasty: a randomized pilot study.
PG  - 34
LID - 10.1186/s12937-016-0153-1 [doi]
LID - 34
AB  - BACKGROUND: Multimodal protocols of perioperative care may enhance postoperative 
      recovery. However, limited information is available on preoperative immune and 
      carbohydrate (CHO)-enriched drinks in patients undergoing hip arthroplasty. We 
      aimed to investigate the effect of a multimodal protocol (ACERTO protocol) plus 
      preoperative immune nutrition on the length of stay (LOS) and the postoperative 
      acute phase response of patients undergoing total hip arthroplasty. METHODS: 
      Thirty-two patients (mean age, 58 years; range, 26-85 years; 16 males) were 
      randomized to receive either the ACERTO protocol (n = 15, ACERTO Group), which 
      consisted of 6 h preoperative fasting for solids, an oral drink (200 mL of 12.5 % 
      maltodextrin) up to 2 h before induction of anesthesia, restricted intravenous 
      fluids (only 1000 mL of crystalloid fluid after surgery) and preoperative immune 
      nutrition (600 mL/day of Impact - Nestle, Brazil) for five days prior to surgery, 
      or traditional care (n = 17; control group), which consisted of 6-8 h 
      preoperative fasting, intravenous hydration until the 1(st) postoperative day and 
      no preoperative immune supplementation. The main endpoint was LOS. C-reactive 
      protein (CRP) was the secondary endpoint and was assessed during induction of 
      anesthesia and on postoperative day 2. RESULTS: Neither deaths nor postoperative 
      complications occurred. The median LOS was 3 (2-5) days in the ACERTO group and 6 
      (3-8) days in controls (P <0.01). Postoperative CRP was higher in the control 
      group (P <0.01). CONCLUSION: The ACERTO multimodal protocol of perioperative care 
      plus preoperative immune nutrition may decrease LOS and postoperative CRP levels 
      in total hip arthroplasty. CLINICAL TRIALS: NCT02580214.
FAU - Alito, Miguel Aprelino
AU  - Alito MA
AD  - Brazilian Society of Orthopedics and Traumatology, Cuiaba, MT, Brazil.
FAU - de Aguilar-Nascimento, Jose Eduardo
AU  - de Aguilar-Nascimento JE
AD  - Federal University of Mato Grosso, Cuiaba, Brazil, Cuiaba, Brazil. 
      aguilar@terra.com.br.
AD  - UNIVAG, Varzea Geande, Brazil. aguilar@terra.com.br.
AD  - , Rodovia Helder Candia, Cond. Country casa 15, 78048-150, Cuiaba, Brazil. 
      aguilar@terra.com.br.
LA  - eng
SI  - ClinicalTrials.gov/NCT02580214
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20160402
PL  - England
TA  - Nutr J
JT  - Nutrition journal
JID - 101152213
RN  - 0 (Dietary Carbohydrates)
RN  - 0 (Dietary Proteins)
RN  - 0 (Fatty Acids, Omega-3)
RN  - 0 (Hemoglobins)
RN  - 0 (Nucleotides)
RN  - 0 (Polysaccharides)
RN  - 0 (Vitamins)
RN  - 7CVR7L4A2D (maltodextrin)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - 94ZLA3W45F (Arginine)
SB  - IM
EIN - Nutr J. 2016;15(1):55. PMID: 27194413
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Arginine/administration & dosage
MH  - *Arthroplasty, Replacement, Hip
MH  - C-Reactive Protein/metabolism
MH  - Dietary Carbohydrates/administration & dosage
MH  - Dietary Proteins/administration & dosage
MH  - Endpoint Determination
MH  - Fatty Acids, Omega-3/administration & dosage
MH  - Female
MH  - Follow-Up Studies
MH  - Hemoglobins/metabolism
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Nucleotides/administration & dosage
MH  - Nutritional Support/*methods
MH  - Perioperative Care/*methods
MH  - Pilot Projects
MH  - Polysaccharides/administration & dosage
MH  - Postoperative Complications/prevention & control
MH  - Preoperative Care
MH  - Prospective Studies
MH  - Vitamins/administration & dosage
PMC - PMC4818928
OTO - NOTNLM
OT  - C-reactive protein
OT  - Immune nutrition
OT  - Length of hospital stay
OT  - Perioperative care
OT  - Preoperative fasting
OT  - Total hip arthroplasty
EDAT- 2016/04/04 06:00
MHDA- 2016/10/21 06:00
PMCR- 2016/04/02
CRDT- 2016/04/04 06:00
PHST- 2015/10/28 00:00 [received]
PHST- 2016/03/30 00:00 [accepted]
PHST- 2016/04/04 06:00 [entrez]
PHST- 2016/04/04 06:00 [pubmed]
PHST- 2016/10/21 06:00 [medline]
PHST- 2016/04/02 00:00 [pmc-release]
AID - 10.1186/s12937-016-0153-1 [pii]
AID - 153 [pii]
AID - 10.1186/s12937-016-0153-1 [doi]
PST - epublish
SO  - Nutr J. 2016 Apr 2;15:34. doi: 10.1186/s12937-016-0153-1.