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Administering Carbohydrates and Omega-3 Fatty Acids Before & During Heart Surgery Reduces Later Complications

by Dr. Lakshmi Venkataraman on April 22, 2017 at 5:39 PM
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Highlights:

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, Cuiab�, Brazil.

Reason For Study

Previous 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.

‘Incidence of atrial fibrillation following coronary artery bypass graft surgery can be reduced by giving carbohydrate and omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplements in the perioperative period.’

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 Study

The study was a randomized, double blind trial (neither patients participating nor the

doctors performing the surgery or involved in collecting the patient data were aware of details of patient selection for nutrient supplementation) conducted in a Brazilian Hospital.

Fifty seven patients undergoing CABG surgery were randomly assigned to 1 of the following 4 groups.

Perioperative clinical and lab parameters and mortality rates were collected and analyzed, examining the incidence of POAF, as well as the need for drugs to maintain blood pressure and heart rate (vasoactive agents) during the operation and in the intensive care unit (ICU) postoperatively.

Results of the Study

In short, perioperative administration of carbohydrate load and ω-3 PUFA infusion improves the outcome for patients undergoing CABG with regards to incidence of POAF, hospital infection, and reliance on vasoactive agents. These led to a shorter hospital stay and quicker recovery.

Role of Carbohydrates and ω-3 PUFA in Surgery Patients

One 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.

Though this is a small study as the authors caution, the benefit of ω-3 PUFA in reducing the incidence of POAF was significant. Further studies involving larger number of patients may be required to validate these findings.

References:

  1. Omega-3 polyunsaturated fatty acids in cardiac surgery patients: An updated systematic review and meta-analysis - (https:www.ncbi.nlm.nih.gov/pubmed/27293143)

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