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«Messenger of Anesthesiology and Resuscitation» Vol 13, №1, 2016,

Effects of pre-operative administration of concentrated glucose in anasthesiological support during pulmonary surgery

V. А. Zhikharev, V. А. Porkhanov, Research Institute of S. V. Ochapovsky Regional Clinical Hospital no. 1, Krasnodar, RF

Yu. P. Malyshev, Kuban State Medical University, Krasnodar, RF

The article presents the experience of use and efficiency of pre-operative carbohydrate administration of 20% glucose intravenously during anasthesiological support of thorax cancer surgery. The article shows the parameters of hemodynamics, results of intra and post-operative laboratory monitoring of glycemia, albumin levels, time of the enteral feeding start, duration of patients’ stay in the intensive care department and duration of the general hospital stay, basing on the above parameters the conclusion has been made about reduction in significance of metabolic stress response to surgical aggression in this category of the patients.

Key words: stress hyperglycemia, video-assisted thoracoscopic lobectomy, epidural space, pre-operative administration of carbohydrate, insulin-resistance.
References

1. Zarechnova N.V., Bel’skiy V.А., Zagaynov V.E. Osobennosti techeniya rannego ­posleoperatsionnogo perioda u bol’nykh posle obshirnykh rezektsiy pecheni. [­Specific course of the early post-operative period in the patients after wide resections of liver]. Med. Almanakh, Spetsvypusk, 2008, pp. 70-73.

2. Lekmanov А.U., Erpuleva Yu.V. Early enteral feeding in critical states. Vestn. Intensivnoy Terapii, 2012, no. 3, pp. 53-56. (In Russ.)

3. Luft V.M., Bagnenko S.F., Scherbuka Yu.А. Rukovodstvo po klinicheskomu pitaniyu. [Guidelines on clinical feeding.] Sankt-Peterburgskiy NII Skoroy Pomoschi im. I.I. Dzhanelidze Publ., St. Petersburg, 2010, pp. 83-102.

4. Malyshev Yu.P. Specific peri-operative management of the patients with concurrent gastroenterological diseases. Vestn. Intensivnoy Terapii, 2014, no. 2, pp. 26-39. (In Russ.)

5. Niradjan N., Bolton T., Beri K. Speeding up rehabilitation after surgery: current achievements. Russian version of Update in Anaesthesia, 2012, no. 26/1, pp. 21-27. (In Russ.)

6. Ovechkin A.M. Surgical stress response, its pathophysiological meaning and ways of modulation. Regionar. Anestesia i Lecheniye Ostroy Boli, 2008, no. 2 (2), pp. 49-62. (In Russ.)

7. Prelous I.N., Leyderman I.N., Nikolaenko А.V. Stress hyperglycemia in critical states, clinical meaning and a new management technique. Infeksii v Khirurgii, 2011, no. 4, pp. 43-46. (In Russ.)

8. 8, Shestopalov А.E., Popova T.S., Leyderman I.N. Nutritivnaya terapiya ­kriticheskikh sostoyaniy. Intens. terapiya: Natsional’noe rukovodstvo. [Nutritional therapy of critical states. Intensive care. National guidelines]. Ed. by B.R. ­Gelfand, A.I. Saltanova, Moscow, GEOTAR-Media Publ., 2011, vol. 1, pp. 202-207. (In Russ.)

9. Andra E. Dunca. Hyperglycemia and Perioperative Glucose Management. Curr. Pharm. Des., 2012, vol. 18, no. 38.

10. Debigare R., Cote C.H., Maltais F. Peripheral muscle wasting in chronic obstructive pulmonary disease: clinical relevance and mechanisms. Am. J. Respir. Crit. Care Med., 2002, vol. 166, pp. 485-489.

11. Desborough J.P. The stress response to trauma and surgery. Br. J. Anaesth., 2000, vol. 85, pp. 109-117.

12. Evans C. H., Lee J., Ruhlman M. K. Optimal glucose management in the perioperative period. Surg. Clin. North. Am., 2015, vol. 95, no. 2, pp. 337-354.

13. King W. Gastric material aspiration. Russian version of Update in Anaesthesia, 2012, no. 26/1, pp. 33-36. (In Russ.)

14. Ljungqvist O., Nygren J., Thorell A. Modulation of post-operative insulin resistance by pre-operative carbohydrate loading. Proc. Nutr Soc., 2002, vol. 61, pp. 329-336.

15. Noblett S.E., Watson D.S., Huong H. et al. Preoperative oral carbohydrate loading in colorectal surgery: a randomized controlled trial. Colorectal Dis., 2006, vol. 8, pp. 563-569.

16. Nygren J., Thorell A., Jacobsson H. et al. Preoperative gastric emptying. Effects of anxiety and oral carbohydrate administration. Ann. Surg., 1995, vol. 222, pp. 728-734.

17. Perreault L., Færch K., Kerege A.A. et al. Hepatic glucose sensing is impaired, but can be normalized, in people with impaired fasting glucose. J. Clin. Endocrinol. Metab., 2014, vol. 99, no. 7, pp. E1154-E1162.

18. Rybka J. Glycaemia control in critically ill patients is justified and effective. Vnitr. Lek., 2010, vol. 56, no. 9 (suppl. pp. 977-987.

19. Smith I., Kranke P., Murat I. et al. Peri-operative abrosia in adults and children: recommendation of European Anesthesiology Society. Vestnik Anasteziol. i Reanimatol., 2013, no. 1, pp. 55-69. (In Russ.)

20. Soop M., Carlson G.L., Hopkinson J. et al. Randomized clinical trial of the effects of immediate enteral nutrition on metabolic responses to major colorectal surgery in an enhanced recovery protocol. Br. J. Surg., 2004, vol. 91, pp. 1138-1145.

21. Tomoko S. Kato, Faisal H. Cheema, Jonathan Yang et al. Preoperative serum albumin levels predict 1-year postoperative survival of patients undergoing heart transplantation, Circulation: Heart Failure, 2013, vol. 6, pp. 785-791.

22. Wolfe R.R., Allsop J.R., Burke J.F. Glucose metabolism in man: responses to ­intravenous glucose infusion. Metabolism, 1979, vol. 28, pp. 210-220.

23. Yuill K.A., Richardson R.A., Davidson H.I. The administration of an oral carbohydrate-containing fluid prior to major elective upper-gastrointestinal surgery preserves skeletal muscle mass postoperatively – a randomised clinical trial. Clin. Nutr., 2005, vol. 24, pp. 32-37.


For citation: V. А. Zhikharev, Yu. P. Malyshev, V. А. Porkhanov Effects of pre-operative administration of concentrated glucose in anasthesiological support during pulmonary surgery «Messenger of Anesthesiology and Resuscitation» 2016; 13(1):24.


For citation: V. А. Zhikharev, Yu. P. Malyshev, V. А. Porkhanov Effects of pre-operative administration of concentrated glucose in anasthesiological support during pulmonary surgery «Messenger of Anesthesiology and Resuscitation» 2016; 13(1):24.