Colorectal Cancer
Conditions
Keywords
colorectal cancer, protein recovery, perioperative nutrition, hyperinsulinemia, normoglycemia, hyperinsulinemic-normoglycemic clamp, anabolism
Brief summary
The purpose of this study is to find out whether adding insulin after current colorectal cancer surgery promotes making and keeping proteins in the body, and to find out whether or not this effect can be further increased by increasing the amount of protein given.
Interventions
DIETARY_SUPPLEMENTTravasol (amino acid injection)
an amino acid supplementation infused intravenously containing essential and non-essential amino acids
DRUGInsulin
After the insertion of an arterial catheter and obtaining a baseline arterial blood glucose value, 2 units of insluin will be administered iv followed by an infusion of 2 microunits/kg\*min. Ten minuts after starting the insulin, and when the the blood glucose is\<6 mmol/L, dextrose 20% supplemented with phosphate (30mmol/L) will be infused. Blood glucose levels measured every 15 minutes and the dextrose infusion rate adjusted to maintain arterial glycemia between 4 and 6 mmol/L until end of study.
Sponsors
Canadian Institutes of Health Research (CIHR)
McGill University Health Centre/Research Institute of the McGill University Health Centre
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* American Society of Anesthesiologists class\<3 * age\>18 years * colorectal surgery for non-metastatic colorectal adenocarcinoma including right and left hemicolectomy, transverse, subtotal and total colectomy sigmoid and low anterior resection * ability to give informed consent
Exclusion criteria
* BMI\>30 Kg/meter squared * confirmed diagnosis of diabetes mellitus or a HbA1c\>6.0% * significant cardiorespiratory, hepatic, renal and neurological disease * musculoskeletal or neuromuscular disease * ingestion of drugs known to affect protein, glucose and lipid metabolism (e.g. steroids) * severe anemia (hemoglobin\<10 g/dL * pregnancy * history of severe sciatica, back surgery or other conditions which contraindicate the use of epidural catheters
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Net protein balance | 6 hours after surgery | The difference in total body protein after randomization to one of the three treatment arms. |
Countries
Canada
Outcome results
None listed