Gastric emptying of three liquid oral preoperative metabolic preconditioning regimens measured by magnetic resonance imaging in healthy adult volunteers: A randomised double-blind, crossover study

Authors: Lobo, D.N., Hendry, P.O., Rodrigues, G., Marciani, L., Totman, J.J., Wright, J.W., Preston, T., Gowland, P., Spiller, R.C. and Fearon, K.C.H.

Journal: Clinical Nutrition

Volume: 28

Issue: 6

Pages: 636-641

ISSN: 0261-5614

DOI: 10.1016/j.clnu.2009.05.002

Abstract:

Background & aims: Preoperative starvation has many undesirable effects but the minimum length of fasting is limited by gastric emptying, which may be dependent on nutrient content, viscosity and osmolarity of the feed. We compared the gastric emptying of two types of preoperative metabolic preconditioning drinks [Oral Nutritional Supplement (ONS) (Fresenius Kabi, Germany) and preOp® (Nutricia Clinical Care, UK)] in healthy volunteers. Methods: Twenty (10 male, 10 female) healthy adult volunteers were studied on 3 separate occasions in a randomised crossover manner. Volunteers ingested 400 ml preOp®, which is a clear carbohydrate drink (CCD) (50 g carbohydrate, 0 g protein), 70 g ONS (50 g carbohydrate and 15 g glutamine) dissolved in water to a total volume of 400 ml (ONS400) and 300 ml (ONS300). Gastric emptying time was measured using magnetic resonance imaging. Results: Mean (95% CI) T50 and T100 gastric emptying times for CCD were significantly lower (p < 0.001) compared with ONS400 and ONS300. T50 was 47 (39-55), 78 (69-87) and 81 (70-92) min for CCD, ONS400 and ONS300 respectively. Correspondingly T100 was 94 (79-110), 156 (138-173) and 162 (140-184) min. Residual gastric volumes returned to baseline 120 min after CCD and 180 min after ONS400 and ONS300. Conclusions: The faster gastric emptying for CCD compared to ONS400 and ONS300 signifies that gastric emptying may be more dependent on nutrient load than volume or viscosity in healthy volunteers. While it is safe to give CCD 2 h preoperatively, ONS400 and ONS300 should be given at least 3 h preoperatively. © 2009 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.

Source: Scopus

Gastric emptying of three liquid oral preoperative metabolic preconditioning regimens measured by magnetic resonance imaging in healthy adult volunteers: a randomised double-blind, crossover study.

Authors: Lobo, D.N., Hendry, P.O., Rodrigues, G., Marciani, L., Totman, J.J., Wright, J.W., Preston, T., Gowland, P., Spiller, R.C. and Fearon, K.C.H.

Journal: Clin Nutr

Volume: 28

Issue: 6

Pages: 636-641

eISSN: 1532-1983

DOI: 10.1016/j.clnu.2009.05.002

Abstract:

BACKGROUND & AIMS: Preoperative starvation has many undesirable effects but the minimum length of fasting is limited by gastric emptying, which may be dependent on nutrient content, viscosity and osmolarity of the feed. We compared the gastric emptying of two types of preoperative metabolic preconditioning drinks [Oral Nutritional Supplement (ONS) (Fresenius Kabi, Germany) and preOp (Nutricia Clinical Care, UK)] in healthy volunteers. METHODS: Twenty (10 male, 10 female) healthy adult volunteers were studied on 3 separate occasions in a randomised crossover manner. Volunteers ingested 400 ml preOp, which is a clear carbohydrate drink (CCD) (50 g carbohydrate, 0 g protein), 70 g ONS (50 g carbohydrate and 15 g glutamine) dissolved in water to a total volume of 400 ml (ONS400) and 300 ml (ONS300). Gastric emptying time was measured using magnetic resonance imaging. RESULTS: Mean (95% CI) T(50) and T(100) gastric emptying times for CCD were significantly lower (p<0.001) compared with ONS400 and ONS300. T(50) was 47 (39-55), 78 (69-87) and 81 (70-92)min for CCD, ONS400 and ONS300 respectively. Correspondingly T(100) was 94 (79-110), 156 (138-173) and 162 (140-184)min. Residual gastric volumes returned to baseline 120 min after CCD and 180 min after ONS400 and ONS300. CONCLUSIONS: The faster gastric emptying for CCD compared to ONS400 and ONS300 signifies that gastric emptying may be more dependent on nutrient load than volume or viscosity in healthy volunteers. While it is safe to give CCD 2h preoperatively, ONS400 and ONS300 should be given at least 3h preoperatively.

Source: PubMed

Gastric emptying of three liquid oral preoperative metabolic preconditioning regimens measured by magnetic resonance imaging in healthy adult volunteers: a randomised double-blind, crossover study

Authors: Lobo, D.N., Hendry, P.O., Rodrigues, G., Marciani, L., Totman, J.J., Wright, J.W., Preston, T., Gowland, P., Spiller, R.C. and Fearon, K.C.H.

Journal: Clinical Nutrition

Volume: 28

Pages: 636-641

Publisher: Churchill Livingstone

Source: Manual

Gastric emptying of three liquid oral preoperative metabolic preconditioning regimens measured by magnetic resonance imaging in healthy adult volunteers: a randomised double-blind, crossover study.

Authors: Lobo, D.N., Hendry, P.O., Rodrigues, G., Marciani, L., Totman, J.J., Wright, J.W., Preston, T., Gowland, P., Spiller, R.C. and Fearon, K.C.H.

Journal: Clinical nutrition (Edinburgh, Scotland)

Volume: 28

Issue: 6

Pages: 636-641

eISSN: 1532-1983

ISSN: 0261-5614

DOI: 10.1016/j.clnu.2009.05.002

Abstract:

Background & aims

Preoperative starvation has many undesirable effects but the minimum length of fasting is limited by gastric emptying, which may be dependent on nutrient content, viscosity and osmolarity of the feed. We compared the gastric emptying of two types of preoperative metabolic preconditioning drinks [Oral Nutritional Supplement (ONS) (Fresenius Kabi, Germany) and preOp (Nutricia Clinical Care, UK)] in healthy volunteers.

Methods

Twenty (10 male, 10 female) healthy adult volunteers were studied on 3 separate occasions in a randomised crossover manner. Volunteers ingested 400 ml preOp, which is a clear carbohydrate drink (CCD) (50 g carbohydrate, 0 g protein), 70 g ONS (50 g carbohydrate and 15 g glutamine) dissolved in water to a total volume of 400 ml (ONS400) and 300 ml (ONS300). Gastric emptying time was measured using magnetic resonance imaging.

Results

Mean (95% CI) T(50) and T(100) gastric emptying times for CCD were significantly lower (p<0.001) compared with ONS400 and ONS300. T(50) was 47 (39-55), 78 (69-87) and 81 (70-92)min for CCD, ONS400 and ONS300 respectively. Correspondingly T(100) was 94 (79-110), 156 (138-173) and 162 (140-184)min. Residual gastric volumes returned to baseline 120 min after CCD and 180 min after ONS400 and ONS300.

Conclusions

The faster gastric emptying for CCD compared to ONS400 and ONS300 signifies that gastric emptying may be more dependent on nutrient load than volume or viscosity in healthy volunteers. While it is safe to give CCD 2h preoperatively, ONS400 and ONS300 should be given at least 3h preoperatively.

Source: Europe PubMed Central