PD1076 - PREOPERATIVE MULTI NUTRIENT NUTRITION SUPPORT AND POSTOPERATIVE GLYCEMIA IN ADULTS UNDERGOING ELECTIVE SURGERY: A NONRANDOMIZED PILOT FEASIBILITY STUDY

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Beyond Carb Loading: Rethinking Preoperative Nutrition

PD1076

PREOPERATIVE MULTI NUTRIENT NUTRITION SUPPORT AND POSTOPERATIVE GLYCEMIA IN ADULTS UNDERGOING ELECTIVE SURGERY: A NONRANDOMIZED PILOT FEASIBILITY STUDY

T. Marx1,*, J. Goldenberg2, B. Zimmerman2

1Physician, Private Practice, Shelton , 2Helfgott Research Institute, National University of Natural Medicine, Portland , United States

 

Rationale: Prolonged preoperative fasting may worsen perioperative metabolic stress. We evaluated the safety, feasibility, and exploratory metabolic effects of preoperative multi nutrient nutrition support in adults undergoing elective surgery.

Methods: In this single center nonrandomized pilot feasibility study, 67 adults undergoing elective surgery received standard care alone or standard care plus a preoperative nutrition intervention administered the evening before surgery and again 4h preoperatively. Baseline characteristics were broadly similar. Primary objectives were safety and feasibility. Glucose differences were assessed using Wilcoxon rank sum tests with Hodges–Lehmann estimates. The study was approved by the JSS Medical College Institutional Ethics Committee on 18 December 2023, and all participants provided written informed consent.

Results: No product attributed adverse events occurred. Gastric clearance was confirmed within 2h after the morning dose in all participants, and no surgery delays were attributed to the intervention. There were no 30 day readmissions or postoperative infections in either arm. Postoperative nausea and vomiting within 6h was similar between groups: 10/33 versus 12/34, p=0.796. Glucose favored intervention at all time points: preoperative 126.06 vs 134.79 mg/dL, perioperative 118.21 vs 129.29 mg/dL, 24 h 121.45 vs 132.62 mg/dL, and 48 h 125.03 vs 136.65 mg/dL. At 48 h, the Hodges–Lehmann estimate was −9.00 mg/dL, p=0.0297.

Conclusion: In this pilot study, preoperative multi nutrient nutrition support was safe and feasible, with an exploratory signal of lower postoperative glucose that reached significance at 48 h. Larger adequately powered studies are warranted.

Disclosure of Interest: T. Marx Other: Founder, CEO, owner, and formulator of TM Nutrition LLC, the company that developed the study intervention, J. Goldenberg: None declared, B. Zimmerman: None declared