None listed
Conditions
Brief summary
ERAS (enhanced recovery after surgery) protocols have been demonstrated to improve certain surgical outcomes. St Vincent’s Hospital Melbourne employs an ERAS protocol for colorectal surgical candidates. Among many measures, is the provision for ingestion of 400ml of carbohydrate fluid 2 hours before surgery. This intervention aims to reduce patient length of stay at no increased risk of aspiration events. Contemporary literature includes several studies that aim to investigate the transit of preoperative carbohydrate ingestion via non-invasive gastric ultrasound, specifically utilising gastric antrum cross sectional area (CSA). These studies find that the transit of carbohydrate oral drinks, ingested at least 2 hours before surgery, do not remain in the stomach upon intubation: the pre-operative ingestion does not appear to increase the risk of pulmonary aspiration caused by an ‘at risk’ stomach. Any potential changes to a patient's haemodynamic state caused by ingestion of this fluid however, have not been investigated to date. Understanding the haemodynamic effect of this intervention would aid the clinician (i.e., the anaesthetist) in their attempt to provide patient-centred, safe, peri-operative fluid management. This is important, as failure to safely manage a patient's fluid status could precipitate deleterious states such as fluid overload (too much fluid) or hypovolemia (too little fluid).
Interventions
Ingestion of carbohydrate pre-operative drink. Specifically, Nutricia PreOp carbohydrate drink. 400ml total volume per candidates. This will be delivered to participants in the presence of a ANZCA Fellow. Each participant will orally ingest this 400ml volume once over the course of 5 minutes. This will occur in a clinical setting i.e, the anaesthetic department of St Vincent's Hospital. Ingestion of this carbohydrate drink is routine for colorectal surgery patients at St Vincent's Hospital. Part
Ingestion of carbohydrate pre-operative drink. Specifically, Nutricia PreOp carbohydrate drink. 400ml total volume per candidates. This will be delivered to participants in the presence of a ANZCA Fellow. Each participant will orally ingest this 400ml volume once over the course of 5 minutes. This will occur in a clinical setting i.e, the anaesthetic department of St Vincent's Hospital. Ingestion of this carbohydrate drink is routine for colorectal surgery patients at St Vincent's Hospital. Participants will be healthy volunteers - not surgical candidates. The drink will be provided to the participant shortly after checking into the trial site. Participants will then be assessed intermittently for a period of 2 hours after ingestion. This will include a baseline assessment using ultrasound, then the same assessment at 30 minutes, 60 minutes and 120 minutes after ingestion.
Sponsors
Dr Harsh Dubey
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Candidates must be available to attend St Vincent’s Hospital Melbourne for the study to be completed and; They must be willing to have an ultrasound probe pressed against specific areas of the body, specifically the abdomen and thorax (to be exact the front left chest) and; They must be willing to fast for 6 hours then ingest carbohydrate-containing liquid drink
Exclusion criteria
Candidates who decline to have ultrasound investigations performed on their thorax or abdomen; or Candidates who are trainees or employees of the anaesthetic department of St Vincent's Hospital Melbourne or Candidates who knowingly have gastric disease or cardiovascular disease (as these conditions will impact the interpretation and usefulness of the results)
Outcome results
None listed