van Hoorn Danny E C, Boelens Petra G, van Middelaar-Voskuilen Mariska C, Nijveldt Robert J, Prins Hubert, Bouritius Hetty, Hofman Zandrie, M'rabet Laura, van Leeuwen Paul A M, van Norren Klaske
Department BMR, Numico Research, Wageningen, The Netherlands.
Nutrition. 2005 Jul-Aug;21(7-8):859-66. doi: 10.1016/j.nut.2004.12.005.
The nutritional status of a patient has been implicated as an important factor in the development of postoperative complications. Fasting before an operation may have detrimental effects on the metabolic state. We hypothesized that there was a positive correlation between preoperative nutritional status and postoperative organ function.
Preoperative feeding was compared with fasting with respect to effects on organ function and biochemical parameters in an animal model of extensive large abdominal surgery. Male Wistar rats were fed ad libitum or fasted for 16 h, after which the arteria mesenterica superior was clamped for 60 min followed by 180 min of reperfusion.
After the ischemic period, heart function was significantly better in animals that were fed ad libitum than in fasted animals. Moreover, after intestinal ischemia and reperfusion, fed rats showed significantly higher levels of intestinal adenosine triphosphate and a significantly higher malondialdehyde concentration in the intestine and lung than did fasted rats. The ratio of adenosine triphosphate to adenosine diphosphate in the liver, an indicator of energy status, in fed rats was similar to that in a sham group, whereas fasted animals showed a significantly lower value.
Preoperative nutrition in contrast to fasting may attenuate ischemia/reperfusion-induced injury and preserve organ function in the rat.
患者的营养状况被认为是术后并发症发生的一个重要因素。手术前禁食可能会对代谢状态产生不利影响。我们假设术前营养状况与术后器官功能之间存在正相关。
在广泛的大腹部手术动物模型中，比较术前喂养与禁食对器官功能和生化参数的影响。雄性Wistar大鼠自由进食或禁食16小时，之后夹闭肠系膜上动脉60分钟，然后再灌注180分钟。
在缺血期后，自由进食的动物心脏功能明显优于禁食动物。此外，在肠缺血再灌注后，喂养的大鼠肠道三磷酸腺苷水平明显高于禁食大鼠，且肠道和肺中的丙二醛浓度也明显更高。作为能量状态指标的肝脏中三磷酸腺苷与二磷酸腺苷的比值，喂养的大鼠与假手术组相似，而禁食动物的值明显更低。
与禁食相比，术前营养可能会减轻大鼠缺血/再灌注诱导的损伤并保护器官功能。
