Heart Surgery, Ischemic Heart Disease
Conditions
Keywords
Enhanced recovery program, carbohydrate loading, coronary artery bypass grafting, heart surgery, postoperative recovery
Brief summary
Enhanced recovery after surgery protocols aim to optimize perioperative care and improve surgical outcomes. Preoperative carbohydrate loading has demonstrated benefits in reducing insulin resistance and improving patient outcomes. While non-diabetic patients benefit from this approach, its efficacy in diabetic type 2 patients undergoing CABG remains less understood. This study aims to address this gab by evaluating the physiological and clinical outcomes for carbohydrate loading in this specific population.
Detailed description
A randomized controlled trial comparing diabetic type 2 patients receiving carbohydrate loading with those undergoing traditional fasting protocols. Patients will be randomized to two groups; group (a) patients will have carbohydrate loading 2 hours before the surgery (400 ml of 12.5 maltodextrin and 400 ml of over-the-counter fruit-based lemonade), while group (b) patients (control group) will have standard fasting protocol 8 hours before surgery. Aims of the study: 1. To assess the efficacy of carbohydrate loading in reducing insulin resistance in diabetic type 2 patients undergoing CABG surgeries. 2. To monitor clinical outcomes such as infection rates, ICU stay duration, and need for inotropic and vasoactive drugs. 3. To evaluate changes in inflammatory markers including CRP levels. clinical outcome
Interventions
DIETARY_SUPPLEMENTCarbohydrate loading before surgery
Carbohydrate loading 2 hours before the surgery (400 ml of 12.5 maltodextrin and 400 ml of over-the-counter fruit-based lemonade)
Sponsors
Damascus University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
All diabetic type 2 patients undergoing isolated on-pump coronary artery bypass surgery.
Exclusion criteria
* Missing data. * Patients outside the study period. * Patients undergoing other cardiac surgeries. * Patients diagnosed with type 1 diabetes mellitus.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Short Insulin Tolerance Test (KITT) | Preoperatively and up to 72 hours postoperatively | Short Insulin Tolerance Test (KITT) will test changes in insulin tolerance postoperatively |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| CRP levels | Preoperatively and up to 72 hours postoperatively | C-Reactive Protein levels in the blood |
| Arterial blood gases | Preoperatively and up to 72 hours postoperatively | Changes in arterial blood gases |
| Operative time | Intraoperatively, skin-to-skin | Total operative time, skin-to-skin |
| CPB duration | Intraoperatively, using extracorporeal circulation | Total time spend using cardiopulmonary bypass perfusion |
| Blood loss | Intraoperatively and up to 72 hours postoperatively | Blood loss and blood product usage |
| Number of grafts performed | Intraoperatively, skin-to-skin | Number of grafts performed during the operation |
| Use of inotrops | Intraoperatively and up to 72 hours postoperatively | Use of inotrops to support the cardiac output |
| Complications | Intraoperatively and up to 72 hours postoperatively | All perioperative complications |
Countries
Syria
Contacts
CONTACTMohammad B Izzat, FRCS(CTh)
CONTACTMohammad S Sioufi, MD
STUDY_DIRECTORMohammad B Izzat, FRCS(CTh)
Damascus University
Outcome results
None listed