title: Shrinking preoperative fast time with maltodextrin and protein hydrolysate in gastrointestinal resections due to cancer.
abstract: OBJECTIVE
  Prolonged preoperative fasting increases postoperative hospital length of stay and current evidence recommends patients drink a carbohydrate-based liquid drink 2 h before surgery. The aim of this study was to investigate whether the addition of hydrolyzed protein to a carbohydrate-based drink would reduce both the inflammatory response and hospital length of stay.
  
  
  METHODS
  We evaluated 22 patients of both sexes, undergoing gastrointestinal resection due to cancer. Patients were randomized into two groups: control group (n = 12; 6-8 h fast) and the intervention group (n = 10; fasted to solids for 6 h; and given a beverage containing 11% pea protein hydrolysate and 89% carbohydrates (79% maltodextrin and 21% sucrose), 400 mL the night before and 200 mL 3 h before surgery. Blood samples were collected the morning before surgery and on postoperative day 2.
  
  
  RESULTS
  Overall mortality was 4.5% (one case, control group). The duration of postoperative hospital stay was twofold longer in the control group (P = 0.04). A significant increase of serum C-reactive protein/albumin ratio was observed in controls compared with the intervention group (P = 0.04).
  
  
  CONCLUSIONS
  The abbreviation of preoperative fasting time to 3 h using a solution containing carbohydrates and hydrolyzed pea proteins reduces the acute-phase inflammatory response and decreases the postoperative length of stay in patients undergoing major surgery for a malignancy.
authors.affiliation: Department of Surgery, Julio Muller University Hospital, Federal University of Mato Grosso, Cuiabá, Brazil.
authors.forename: Paula Alves
authors.initials: PA
authors.lastname: Pexe-Machado
authors.forename: Benedito Dario
authors.initials: BD
authors.lastname: de Oliveira
authors.forename: Diana Borges
authors.initials: DB
authors.lastname: Dock-Nascimento
authors.forename: Jose Eduardo
authors.initials: JE
authors.lastname: de Aguilar-Nascimento
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000378:metabolism; D005215:Fasting; D005260:Female; D041981:Gastrointestinal Tract / Q000601:surgery; D006801:Humans; D007328:Insulin / Q000097:blood; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery; D011134:Polysaccharides / Q000008:administration & dosage*; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods*; D011492:Protein Hydrolysates / Q000008:administration & dosage*; D012709:Serum Albumin / Q000032:analysis; D016037:Single-Blind Method
chemical_list: D001786:Blood Glucose; D007328:Insulin; D011134:Polysaccharides; D011492:Protein Hydrolysates; D012709:Serum Albumin; C008315:maltodextrin; D002097:C-Reactive Protein