Preoperative Carbohydrate Loading
Preoperative Carbohydrate Loading
A carbohydrate drink (a 12-ounce clear beverage or a 24-g complex carbohydrate beverage) 2 hours preoperatively reduces insulin resistance and tissue glycosylation, improves postoperative glucose control, and enhances return of gut function. In a 2003 Cochrane review of patients undergoing cardiac surgery (CS), carbohydrate loading reduced postoperative insulin resistance and hospital length of stay. In a large randomized clinical trial in patients undergoing CS, preoperative carbohydrate administration was found to be safe and improved cardiac function immediately after cardiopulmonary bypass. However, it did not affect postoperative insulin resistance. Given the current minimal supportive data in patients undergoing CS, carbohydrate loading is given a weak recommendation at this time (class IIb, level C-LD).
