Abstract
Objective: To identify in the scientific production the occurrence of metabolic changes in the postoperative period of elective surgeries and their relation with preoperative fasting time. Method: An integrative review carried out from June to July 2020 in the LILACS, MEDLINE, CINAHL, COCHRANE, SCOPUS, and EMBASE databases. Articles from 2015 to 2020 were selected. For the analysis of the evidence levels, the Oxford Centre for Evidence-Based Medicine categorization was followed. Results: A total of 10 scientific articles were selected. The metabolic changes found were hyperglycemia, elevated serum levels of IL-6, cortisol, and valine, increased insulin resistance, decreased glutamic acid plasma levels, and increased IGF-1 levels with a reduction of IGFBP-3. Shortening the fasting time minimizes the patient's organic stress, with a reduction of metabolic changes, hospitalization time and morbidity. Conclusion: Preoperative fasting time longer than eight hours is related to metabolic changes in the postoperative period...
References
Barbosa MV, Queiroz FM, Pinho NB, Martucci RB. Impact of the use of immunomodulatory diet in colorectal cancer patients under elective surgeries with preoperative fasting abbreviation. Rev Bras Cancerol 2015 Jul/Sep [cited 04 Sep 2020];61(3):217-225. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-833859.
Martins AJC, Serva CAS, Fonseca TH, Martins MJL, Poveda VB. Fasting of less than eight hours in urgent and emergency surgeries versus complication. Rev Bras de Enferm 2016 Nov;69(4):712-7. Doi: https://doi.org/10.1590/0034-7167.2016690414i.
Aguilar-Nascimento JE, Salomão AB, Waitzberg DL, Dock-Nascimento DB, CORREA MITD, Campos ACL, et al. Acerto guidelines of perioperative nutritional interventions period in elective general surgery. Rev Col Bras Cir 2017 Dec;44(6):633-648. Doi: https://doi.org/10.1590/0100-69912017006003.
Carvalho CALB, Carvalho AA, Nogueira PLB, Aguilar-Nascimento JE. Changing paradigms in preoperative fasting: results of a joint effort in pediatric surgery. Arq Bras Cir Dig 2017 Jan/Mar;30(1):7-10. Doi: https://doi.org/10.1590/0102-6720201700010003.
Mendes KDS, Silveira RCCP, Galvao CM. Integrative literature review: a research method to incorporate evidence in health care and nursing. Text Context Enferm 2008 Oct/Dec;17(4):758-764. Doi: https://doi.org/10.1590/S0104-07072008000400018.
The Joanna Briggs Institute. Joanna Briggs Institute Reviewers’ Manual: 2015 [cited 13 Jul 2020]. 2015. p. 7. Available from: https://nursing.lsuhsc.edu/JBI/docs/ReviewersManuals/Scoping-.pdf.
Oxford Centre for Evidence-based Medicine: levels of evidence [Internet]. 2009 Mar [cited 2014 dez 20]. Available from: http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009.
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Epidemiol. Serv. Saúde 2015 Jun;24(2):335-342. Doi: https://doi.org/10.5123/S1679-49742015000200017.
Pędziwiatr M, Pisarska M, Matłok M, Major P, Kisielewski M, Wierdak M, et al. Randomized Clinical Trial to Compare the Effects of Preoperative Oral Carbohydrate Loading versus Placebo on Insulin Resistance and Cortisol Level after Laparoscopic Cholecystectomy. Polski Przegląd Chirurgiczny. 2015 Aug;87(8):402–408. Doi: https://doi.org/10.1515/pjs-2015-0079. [incluída na revisão]
Bang P, Thorell A, Carlsson-Skwirut C, Ljungqvist O, Brismar K, Nygren J. Free dissociable IGF-I: Association with changes in IGFBP-3 proteolysis and insulin sensitivity after surgery. Clinical Nutrition 2016 Mar;(35):408-413. Doi: https://doi.org/10.1016/j.clnu.2015.03.003. [incluída na revisão]
Dilmen OK, Yenturb E, Tunalia Y, Balcic H, Bahar M. Does preoperative oral carbohydrate treatment reduce thepostoperative surgical stress response in lumbar disc surgery? Clinical Neurology and Neurosurgery 2017 Dec;(153):82–86. Doi: https://doi.org/10.1016/j.clineuro.2016.12.016. [incluída na revisão]
Kreutzenberg S, Vigili D, Avogaro A. The role of point-of-care 3-hydroxybutyrate testing in patients with type 2 diabetes undergoing coronary angiography. J Endocrinol Invest 2017 Feb;(40):627–634. Doi: https://doi.org/10.1007/s40618-017-0615-0. [incluída na revisão]
Burstal RJ, Reilly JR, Burstal B. Fasting Or Starving? Measurement of Blood Ketone Levels in 100 Fasted Elective and Emergency Adult Surgical Patients at An Australian Tertiary Hospital. Anaesth Intens Care 2018 Sep;46(5):463-467. Doi: https://doi.org/10.1177/0310057X1804600506. [incluída na revisão]
Hosny H, Desa MI, El-Siory W, Abdel-Monem A. Comparative Study Between Conventional Fasting Versus Overnight Infusion of Lipid or Carbohydrate on Insulin and Free Fatty Acids in Obese Patients Undergoing Elective On-pump Coronary Artery Bypass Grafting. A Prospective Randomized Trial. Journal of Cardiothoracic and Vascular Anesthesia 2018 Jun;(32):1248–1253. Doi: https://doi.org/10.1053/j.jvca.2017.11.020. [incluída na revisão]
Reis PGA, Polakowski C, Lopes M, Bussyguin DS, Ferreira RP, Preti VB. Abbreviated preoperative fasting favours postoperative oral intake at lower hospital admission costs for cancer patients. Rev Col Bras Cir 2019 Aug;46(3):e20192175. Doi: https://doi.org/10.1590/0100-6991e-20192175. [incluída na revisão]
Yeniay O, Tekgul ZT, Okur O, Koroglu N. Unexpectedly prolonged fasting and its consequences on elderly patients undergoing spinal anesthetics. A prospective observational study. Acta Cir Bras 2019 Mar;34(3):e201900309. Doi: https://doi.org/10.1590/s0102-865020190030000009. [incluída na revisão]
Wuensch T, Quint J, Mueller V, Mueller A, Wizenty J, Kaffarnik M, et al. Identification of serological markers for pre and postoperative fasting periods. Clin Nutr ESPEN 2019 Apr;(30):131-137. Doi: https://doi.org/10.1016/j.clnesp.2019.01.004. [incluída na revisão]
Liu B, Wang Y, Liu S, Zhao T, Zhao B, Jiang X, et al. A randomized controlled study of preoperative oral carbohydrate loading versus fasting in patients undergoing elective craniotomy. Clin Nutr 2019 Nov;38(5):2106-2112. Doi: https://doi.org/10.1016/j.clnu.2018.11.008. [incluída na revisão]
Udayasankar M, Udupi S, Shenoy A. Comparison of perioperative patient comfort with ‘enhanced recovery after surgery (ERAS) approach’ versus ‘traditional approach’ for elective laparoscopic cholecystectomy. Indian J Anaesth 2020 Apr;64(4):66-71. Doi: https://doi.org/10.4103/ija.IJA_782_19.
Marquini GV, Pinheiro FES, Vieira AUC, Pinto RMC, Uyeda MGBK, Batista MJ, et al. Preoperative fasting abbreviation (Enhanced Recovery After Surgery protocol) and its effects on the metabolism of patients undergoing gynecologic surgeries under spinal anesthesia: A randomized clinical trial. Nutrition 2020 Mar;77:110790. Doi: https://doi.org/10.1016/j.nut.2020.110790.
Jovanovski-Srceva M, Kuzmanovska B, Mojsova M, Kartalov A, Shosholcheva M, Temelkovska-Stevanoska M, et al. Insulin resistance, glycemia and cortisol levels in surgical patients who had preoperative caloric load with amino acids. Prilozi (Makedonska Akademija na Naukite i umetnostite. Oddelenie za Medicinski Nauki) 2015 Jan;36(3):61-70. Doi: https://doi.org/10.1515/prilozi-2015-0079.
Dogra P, Jialal I. Diabetic Perioperative Management. Dasgupta A, Sepulveda JL. Accurate Results in the Clinical Laboratory: a guide to error detected and correction. Elsevier 2 ed. 2020. p. 165-189. Available from: https://www.ncbi.nlm.nih.gov/books/NBK540965/.
Pontes JPJ, Mendes FF, Vasconcelos MM, Batista NR. Evaluation and perioperative management of patients with diabetes mellitus. A challenge for the anesthesiologist. Rev Bras Anestesiol 2018 Jan/Feb;68(1):75-86. Doi: https://doi.org/10.1016/j.bjan.2017.04.017.
Marcarini M, Rosa SC, Wieck FP, Betti AH. Reduced preoperative fasting time: the perioperative clinical aspects related to cardiac surgical patients. Braspen J 2017 Oct/Dec [cited 08 Jun 2020];32(4):375-379. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-906846.
Rettig TCD, Verwijmeren L, Dijkstra IM, Boerma D, Van de Garde EMW, Noordzij PG. Postoperative Interleukin-6 Level and Early Detection of Complications After Elective Major Abdominal Surgery. Ann Surg 2016 Jun;263(6):1207-12. Doi: https://doi.org/10.1097/SLA.0000000000001342.
Gutefeldt K, Hedman CA, Thyberg ISM, Bachrach‐Lindström M, Spångeus A, Arnqvist HJ. Dysregulated Growth Hormone-Insulin-Like Growth Factor -1 Axis in Adult Type 1 Diabetes with Long Duration. Clinical Endocrinology 2018 Jul;89(4):424-430. Doi: https://doi.org/10.1111/cen.13810.
Lende TH, Austdal M, Varhaugvik AE, Skaland I, Gudlaugsson E, Kvaløy JT. Influence of pre-operative oral carbohydrate loading vs. standard fasting on tumor proliferation and clinical outcome in breast cancer patients ─ a randomized trial. BMC Cancer 2019 Nov;(19):1076. Doi: https://doi.org/10.1186/s12885-019-6275-z.
Vázquez-Martínez O, Méndez I, Turrubiate I, Valente-Godínez H, Pérez-Mendoza M, García-Tejada P, Díaz-Munõz M. Restricted feeding modulates the daily variations of liver glutamate dehydrogenase activity, expression, and histological location. Exp Biol Med (Maywood) 2017 May;(242):945e52. Doi: https://doi.org/10.1177/1535370217699533.
Azevedo SCL, Campos SBG; Meira JEC; Guedes GS. Abreviação do jejum pré-operatório: protocolo multimodal baseado em evidência. Gep News, 2017 Jul/Set [cited 2020 Jul 14];1(3):11-13. Available from: https://www.seer.ufal.br/index.php/gepnews/article/view/3495.
Francisco SC, Batista ST, Pena GG. Fasting in elective surgical patients: comparison among the time prescribed, performed and recommended on perioperative care protocols. ABCD Arq Bras Cir Dig 2015 Nov/Dec;28(4):250-254. Doi: https://doi.org/10.1590/S0102-6720201500040008.
Teixeira UF, Goldoni MB, Waechter FL, Sampaio JA, Mendes FF, Fontes PR. Enhanced recovery (ERAS) after liver surgery: comparative study in a Brazilian terciary center. ABCD Arq Bras Cir Dig 2019 Feb;32(1):e1424. Doi: https://doi.org/10.1590/0102-672020180001e1424.
Lucchesi FA, Gadelha PCFP. Nutritional status and evaluation of the perioperative fasting time among patients submitted to elective and emergency surgeries at a reference hospital. Rev Col Bras Cir 2019 Oct;46(4):e20192222. Doi: https://doi.org/10.1590/0100-6991e-20192222.
Milagros De Luca, Cecilia Mabel Maidana, Denise Moscardi Pietrasanta, Sandra Viviana Velazquez y Patricia Laura Ruscitti. Duración del ayuno preoperatorio en pacientes con cirugía programada. Rev. Hosp. Ital. B. Aires 2019 Sept [cited 17 Oct 2020];39(3):77-80. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1048219.
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