- Complications such as post-operative atrial fibrillation (POAF) and infection may occur after coronary artery bypass graft (CABG) surgery and can retard recovery.
- Carbohydrate and omega-3 fatty acid administration to the patient in the perioperative period can reduce these complications and aid recovery
Carbohydrate and omega(ω)-3 PUFA nutrients
given in the perioperative period is beneficial for recovery of patients undergoing CABG, according to a research team at General
University Hospital, Cuiabá, Brazil.
Reason For StudyPrevious studies have shown that preoperative carbohydrate loading is beneficial in reducing occurrence of post-operative insulin resistance. Also incidence of post-operative nausea and vomiting (PONV) was decreased.
In addition various studies have shown that perioperative supplementation of ω-3 PUFA improved post-operative outcome in patients undergoing abdominal surgery. A recent study has also indicated that perioperative ω-3 PUFA administration was associated with a better outcome in patients who underwent open heart surgery.
The current study aimed to assess incidence of post-operative atrial fibrillation and patient morbidity following surgery by combining a regimen of pre-operative carbohydrate loading followed by intraoperative ω-3 PUFA infusion.
Methods of the StudyThe study was a randomized, double blind trial (neither patients participating nor the
Fifty seven patients undergoing CABG surgery were randomly assigned to 1 of the following 4 groups.
- Only preoperative carbohydrate loading (CHO group) - 14 patients
- Preoperative water only (controls) - 14 patients
- Preoperative carbohydrate loading plus intraoperative ω-3 PUFA infusion (CHO + W3 group) - 15 patients
- Only intraoperative ω-3 PUFA infusion (W3 group) - 14 patients
Results of the Study
- Patients who received carbohydrate (CHO) supplementation had lesser incidence of hospital infection.
- Patients who received CHO supplementation had a lesser requirement of vasoactive agents during the operation and during the ICU stay after the operation.
- Incidence of POAF was markedly less in patients who received ω-3 PUFA infusion during the surgery.
Role of Carbohydrates and ω-3 PUFA in Surgery PatientsOne of the emerging trends in surgery patients is doing away with a prolonged fasting period prior to surgery. Many anesthesiologist groups and societies have begun to endorse this practice.
- A carbohydrate load given 2 hours prior to surgery has been shown to decrease insulin resistance following surgery, decrease nausea and vomiting postoperatively as well as pangs of hunger and thirst after surgery.
- Omega-3 PUFA containing nutrients have been found to reduce incidence of infection and inflammation following surgery. In addition, they are believed to possess anti-arrhythmic properties as well and can decrease incidence of atrial fibrillation in patients undergoing surgery.
- In the field of Cardiology, ω-3 PUFA has been proven to be of benefit in controlling dyslipidemias and inherent complications.
- Omega-3 polyunsaturated fatty acids in cardiac surgery patients: An updated systematic review and meta-analysis - (https://www.ncbi.nlm.nih.gov/pubmed/27293143)