Does a Preoperative Carbohydrate Drink Reduce Postoperative Inflammation? A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Literature Search
2.2. Inclusion and Exclusion Criteria
2.3. Data Collection
2.4. Data Extraction
2.5. Risk of Bias
2.6. Statistical Analysis
3. Results
3.1. Study Selection
3.2. Study Characteristics
3.3. Risk of Bias
3.4. Primary Outcomes
3.5. Secondary Outcomes
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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PICOS | Inclusion Criteria | Exclusion Criteria |
---|---|---|
Population | Adults ≥ 18 years, elective surgical patients | Children < 18 years, animals, non-elective surgical patients, diabetes patients |
Intervention | CHD 2–3 h preoperatively | Lack of CHD 2–3 h preoperatively, non-carbohydrate-containing drink, additional interventions alongside CHD |
Comparison | Fasting ≥ 6 h, non-carbohydrate-containing PD | Carbohydrate-containing PD, No fasting or PD comparator |
Outcomes | IL-6 and/or CRP and/or serum albumin levels 10–24 h postoperatively, mean levels available with CIs | IL-6 or CRP or serum albumin levels not within this time frame, lack of these inflammatory markers, mean levels with CIs not available |
Study Design | RCTs | Other study designs |
Study | Date | Country | Type of Surgery | Sample Size (M/F) | Relevant Cohorts | Contents of CHD | Volume and Timing of Drink(s) and Fasting | Outcomes Measured |
---|---|---|---|---|---|---|---|---|
Hu et al. [19] | 2021 | China | Prostatectomy | 90 (90/0) | (1) CHD (2) Fasting (3) Placebo | 12.6% carbohydrate solution | Drinks—400 m 2–3 h preop, Fasting—6 h preop | IL-6 |
Kweon et al. [28] | 2020 | Korea | Femur fracture nailing | 88 (28/60) | (1) CHD (2) Fasting | 12.8% carbohydrate solution (vitamin A, B, C, D, E, and K, carbohydrate 15 g, fat 3 g, protein 4 g, vitamin A 75 ug, B1 0.13 mg, B2 0.15 mg, B6 0.15 mg, C 14 mg, D 1 ug, E 1.5 mg, K 7.5 ug per 100 mL) | Drink—400 mL 2 h preop, Fasting—7–8 h preop | IL-6 |
Deng et al. [29] | 2020 | China | Hip fracture surgery | 40 (12, 28) | (1) CHD (3) Placebo | 10% carbohydrate solution (14% whey protein) | Drinks—200 mL 3 h preop | CRP, Serum Albumin |
Gumus et al. [30] | 2020 | Turkey | Cholecystectomy | 66 (12, 54) | (1) CHD (2) Fasting | 12.5% carbohydrate solution | Drink—400 m 2 h proper, Fasting—12 h preop | CRP, Serum Albumin |
Zhang et al. [31] | 2020 | China | Gynaecological surgery | 58 (0, 58) | (1) CHD (2) Fasting | 12.5% carbohydrate solution | Drink—400 mL 2 h preop, Fasting—8 h preop | IL-6, CRP |
Rizvanović et al. [16] | 2019 | Bosnia and Herzegovina | Colorectal surgery | 50 (27, 23) | (1) CHD (2) Fasting | 12.5% carbohydrate solution | Drink—200 mL 2 h preop, Fasting—8 h preop | IL-6, CRP, Serum Albumin |
Dilmen et al. [32] | 2017 | Turkey | Lumbar discectomy or laminectomy | 40 (20, 20) | (1) CHD (2) Fasting | 12.5% carbohydrate solution | Drink—400 mL 2 h preop, Fasting—8 h preop | IL-6 |
Dock-Nascimento et al. [33] | 2012 | Brazil | Cholecystectomy | 48 (0, 48) | (1) CHD (2) Fasting (3) Placebo | 12.5% carbohydrate solution | Drinks—200 mL 2 h preop, Fasting—8 h preop | IL-6, CRP, Serum Albumin |
Perrone et al. [24] | 2011 | Brazil | Cholecystectomy or inguinal hernia repair | 17 (6, 11) | (1) CHD (3) Placebo | 86% carbohydrate solution (14% whey protein) | Drinks—237 mL 3 h preop | CRP, Serum Albumin |
Kaška et al. [34] | 2010 | Czech Republic | Colorectal surgery | 221 (122, 99) | (1) CHD (2) Fasting | 12.6% carbohydrate solution (Na 50 mg, K 122 mg, Cl 6 mg, Ca 6 mg, P 1 mg, Mg 1 mg) | Drink—400 mL 2 h preop, Fasting—6–12 h preop | CRP |
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Haider, K.Z.; Ahmed, Z. Does a Preoperative Carbohydrate Drink Reduce Postoperative Inflammation? A Systematic Review and Meta-Analysis. Trauma Care 2023, 3, 294-307. https://doi.org/10.3390/traumacare3040025
Haider KZ, Ahmed Z. Does a Preoperative Carbohydrate Drink Reduce Postoperative Inflammation? A Systematic Review and Meta-Analysis. Trauma Care. 2023; 3(4):294-307. https://doi.org/10.3390/traumacare3040025
Chicago/Turabian StyleHaider, Khasim Zakaria, and Zubair Ahmed. 2023. "Does a Preoperative Carbohydrate Drink Reduce Postoperative Inflammation? A Systematic Review and Meta-Analysis" Trauma Care 3, no. 4: 294-307. https://doi.org/10.3390/traumacare3040025