Effect of Preoperative Carbohydrate Loading on Serum Lactate Levels in Patients Undergoing Donor Hepatectomy
20 juli 2026 uppdaterad av: Mian Usman Hameed, Shifa International Hospital
Effect of Preoperative Carbohydrate Loading on Perioperative Serum Lactate Levels in Patients Undergoing Donor Hepatectomy: A Randomized Controlled Trial
This randomized controlled trial investigated whether preoperative carbohydrate loading reduces perioperative serum lactate levels in patients undergoing donor hepatectomy.
Participants were randomized into two groups: an intervention group receiving a standardized oral carbohydrate drink 2-4 hours before surgery, and a control group undergoing standard preoperative fasting.
Serum lactate levels were measured at five perioperative time points: induction of anaesthesia, before graft removal, 30 minutes after graft removal, before extubation, and in the post-anaesthesia care unit.
The study aimed to determine whether this simple nutritional intervention could improve metabolic preparedness and reduce anaerobic stress in living liver donors.
Studieöversikt
Status
Avslutad
Intervention / Behandling
Detaljerad beskrivning
Prolonged preoperative fasting induces peripheral insulin resistance, glycogen depletion, and a catabolic metabolic state that predisposes patients to anaerobic metabolism during major surgery. Donor hepatectomy is a physiologically demanding procedure associated with significant ischaemia-reperfusion stress and an inherent risk of perioperative lactate accumulation.
Preoperative carbohydrate loading has been proposed as a simple nutritional intervention to attenuate fasting-related metabolic stress by preserving glycogen stores and improving insulin sensitivity. However, its specific effect on serum lactate levels in living liver donors undergoing donor hepatectomy remains underexplored.
This prospective randomized controlled trial was conducted at the Department of Anaesthesiology, Shifa International Hospital, Islamabad. Seventy adult patients aged 18-50 years scheduled for elective donor hepatectomy were enrolled and randomized into two equal groups. The intervention group received a standardized oral carbohydrate drink (maltodextrin solution) 2-4 hours before surgery, while the control group underwent standard preoperative fasting. Serum lactate levels were measured at five perioperative time points. Between-group comparisons were performed using the Mann-Whitney U test, and temporal trends were assessed using repeated measures ANOVA.
Studietyp
Interventionell
Inskrivning (Faktisk)
70
Fas
- Inte tillämpbar
Kontakter och platser
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Studieorter
-
-
Federal
-
Islamabad, Federal, Pakistan, 44000
- Shifa International Hospital
-
-
Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
Tar emot friska volontärer
Ja
Beskrivning
Inclusion Criteria:
- Age 18 to 50 years Either gender Scheduled for elective donor hepatectomy
Exclusion Criteria:
- Known metabolic disorders Pre-existing liver dysfunction
Studieplan
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: Intervention Group
Participants received a standardized oral carbohydrate drink (maltodextrin solution) 2-4 hours before induction of anaesthesia
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Standardized oral carbohydrate drink (maltodextrin solution) administered 2-4 hours prior to induction of anaesthesia
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Inget ingripande: Control Group
Participants underwent standard preoperative fasting protocol without carbohydrate loading
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Perioperative Serum Lactate Level
Tidsram: From induction of anaesthesia through to PACU (approximately 6-8 hours)
|
Serum lactate measured in mmol/L at five perioperative time points: induction of anaesthesia, before graft removal, 30 minutes post graft removal, before extubation, and in the post-anaesthesia care unit (PACU)
|
From induction of anaesthesia through to PACU (approximately 6-8 hours)
|
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Sponsor
Publikationer och användbara länkar
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Allmänna publikationer
- Joshi GP, Abdelmalak BB, Weigel WA, Harbell MW, Kuo CI, Soriano SG, Stricker PA, Tipton T, Grant MD, Marbella AM, Agarkar M, Blanck JF, Domino KB. 2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration-A Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting. Anesthesiology. 2023 Feb 1;138(2):132-151. doi: 10.1097/ALN.0000000000004381.
- Joliat GR, Kobayashi K, Hasegawa K, Thomson JE, Padbury R, Scott M, Brustia R, Scatton O, Tran Cao HS, Vauthey JN, Dincler S, Clavien PA, Wigmore SJ, Demartines N, Melloul E. Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022. World J Surg. 2023 Jan;47(1):11-34. doi: 10.1007/s00268-022-06732-5. Epub 2022 Oct 30.
- Kumar M, Patil NS, Mohapatra N, Yadav A, Sindwani G, Dhingra U, Thomas S, Pamecha V. Preoperative carbohydrate loading reduces perioperative insulin resistance and hastens functional recovery of remnant liver after living donor hepatectomy: An open-label randomized controlled trial. Hepatol Int. 2025 Oct;19(5):1151-1161. doi: 10.1007/s12072-025-10831-5. Epub 2025 May 19.
- Recknagel S, Rademacher S, Hohne C, Lederer AA, Lange UG, Herta T, Seehofer D, Sucher R, Scheuermann U. Prediction of the Postoperative Outcome in Liver Resection Using Perioperative Serum Lactate Levels. J Clin Med. 2023 Mar 7;12(6):2100. doi: 10.3390/jcm12062100.
- Baumgartner R, Engstrand J, Rajala P, Grip J, Ghorbani P, Sparrelid E, Gilg S. Comparing the accuracy of prediction models to detect clinically relevant post-hepatectomy liver failure early after major hepatectomy. Br J Surg. 2024 Jan 3;111(1):znad433. doi: 10.1093/bjs/znad433.
- Zhang Y, Min J. Preoperative Carbohydrate Loading in Gynecological Patients Undergoing Combined Spinal and Epidural Anesthesia. J Invest Surg. 2020 Aug;33(7):587-595. doi: 10.1080/08941939.2018.1546352. Epub 2019 Jan 15.
- Kumar SM, Anandhi A, Sureshkumar S, Keerthi AR, Raja K, Jha AK, Bobby Z, Kate V. Effect of preoperative oral carbohydrate loading on postoperative insulin resistance, patient-perceived well-being, and surgical outcomes in elective colorectal surgery: a randomized controlled trial. J Gastrointest Surg. 2024 Oct;28(10):1654-1660. doi: 10.1016/j.gassur.2024.07.027. Epub 2024 Aug 12.
- Crowley K, Scanaill PO, Hermanides J, Buggy DJ. Current practice in the perioperative management of patients with diabetes mellitus: a narrative review. Br J Anaesth. 2023 Aug;131(2):242-252. doi: 10.1016/j.bja.2023.02.039. Epub 2023 Apr 13.
- Tong E, Chen Y, Ren Y, Zhou Y, Di C, Zhou Y, Shao S, Qiu S, Hong Y, Yang L, Tan X. Effects of preoperative carbohydrate loading on recovery after elective surgery: A systematic review and Bayesian network meta-analysis of randomized controlled trials. Front Nutr. 2022 Nov 23;9:951676. doi: 10.3389/fnut.2022.951676. eCollection 2022.
Studieavstämningsdatum
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Studera stora datum
Studiestart (Faktisk)
1 december 2024
Primärt slutförande (Faktisk)
30 augusti 2025
Avslutad studie (Faktisk)
30 augusti 2025
Studieregistreringsdatum
Först inskickad
20 juli 2026
Först inskickad som uppfyllde QC-kriterierna
20 juli 2026
Första postat (Faktisk)
23 juli 2026
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
23 juli 2026
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
20 juli 2026
Senast verifierad
1 juli 2026
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- IRB 479-24
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