Prolonged preoperative fasting and prognosis in critically ill gastrointestinal surgery patients

Gang Zhou ； Fengxue Zhu ； Youzhong An ； Lixia Qin ； Jie Lv ； Xiujuan Zhao ； Jiawei Shen

《Asia Pacific Journal of Clinical Nutrition》 29卷1期 (2020/03) Pp. 41-47

https://doi.org/10.6133/apjcn.202003_29(1).0006

摘要

Background and Objectives: This study aimed to assess the influence of prolonged preoperative fasting on prognosis in elective surgery. Methods and Study Design: A retrospective, controlled study involving patients admitted to our surgical intensive care unit who underwent a gastrointestinal operation under general anesthesia. Patients were divided into regular preoperative fasting time (n=57) and prolonged preoperative fasting time (n=73) groups. Clinical data were collected including patients' demographics, intraoperative and postoperative operation time, volume of blood loss, intensive care unit stay, hospital stay, postoperative complications and other factors. Results: Patients in the regular preoperative fasting time group had less duration of mechanical ventilation support after surgery [245 (177, 450) min vs 315 (210, 812) min (p=0.021)] and the postoperative myocardial injuries (myocardial injury 2 cases vs 11 cases, p=0.038) and reoperation percentages (reoperation 0 cases vs 7 cases, p=0.044) were lower compared to the prolonged preoperative fasting time group. In addition, patients in the regular preoperative fasting time group presented with a significantly shorter period of postoperative fasting time [6.0 (5.0, 8.0) vs 8.0 (6.0, 13.0), p=0.005]. Conclusions: Prolonged preoperative fasting time led to unfavorable outcomes after gastrointestinal operations. Thus, reducing preoperative fasting time is likely to accelerate postoperative recovery in gastrointestinal surgery patients.

關鍵字

fasting ； gastrointestinal surgery ； elective surgery ； myocardial injury ； reoperation