IMPACT OF THE FASTING ABBREVIATION ON THE SURGICAL PATIENT (Atena Editora)

Abstract

This paper aims to analyze the effects of carbohydrate loading protocol in surgical patients who underwent elective surgeries at the Hospital Rede D´Or São Luiz Villa Lobos Unit – São Paulo. A liquid diet with carbohydrate and protein was sent to the patients: when the surgery took schedule in the morning, a fat-free supplement (Fresubin Jucy) - kit 01 - was delivered at 11 pm the day before. Those who had surgery in the afternoon were given a fat-free supplement (Fresubin Jucy) up to four hours before surgery. Grade II and III obese patients, with significant gastroesophageal disorders, pyloric stenosis syndrome, GIT obstructive cancer, diabetic patients with blood glucose above 180 mg/dL and hospitalization less than four hours prior to surgery were excluded from the protocol. We evaluated 1633 patients hospitalized for elective surgery (orthopedics, urology, general surgery, vascular, gynecology, neurology, plastic surgery, otorhinolaryngology). The fasts of 161 patients (10% of all surgical patients) were shortened. The total length of hospital stay for patients who did not receive the fasting abbreviation kit (n=1271) was 3,937 ± 7,876 days against 2,708 ± 1,592 days for those (n=161) whose protocol was applied (P<0.0001-CI95% 3,534 -4,340 vs CI95% 2,460-2,956). As for hospital costs, we found a significant association with shorter hospital stay (mean time 3,816 ± 0.1857 N1633 CI95% 3,451-4,180) and lower hospital costs (mean R$ 23,603.00 ± 1581 95%CI 20,502-26,703) by Spearman's correlation (P<0.0001). The mean hospital costs among the group of patients with carbohydrate loading protocol was BRL 16,386.00 ± 1221 (95%CI 13,975-18,798) and mean length of stay of 2,708 ± 0.1254 days (95%CI 2,460-2,956) against BRL 24,392 .00 ± 1747 (95%CI 20,964-27,820) and length of stay of 3,937 ± 0.2053 days (95%CI 3,534-4,340) of patients whose fasting was not shortened, showing a reduction of approximately 13% in the total costs of surgeries and one day less of hospitalization. Fasting time ≥ 11.5 hours, patients were 264.8 times more likely to have nausea and/or vomiting. Therefore, fasting abbreviation is safe, it is possible to reduce length of stay in the institution by one day, hospital costs by approximately 13%, prevent nausea, vomiting and postoperative complications.