Carb loading

Carboloading (also: carbohydrate (s) loading ) is a concept of supply of carbohydrate-rich foods before a big endurance exercise of the human body.

Endurance sports

In sport , carb-loading is a strategy that is often used by athletes in endurance sports to ensure that glycogen stores are built up in the muscles . Many athletes therefore consume large amounts of carbohydrates the evening before the competition. This measure is also known in sports circles as the pasta party .

Preoperative carb loading

A comparable concept is also being discussed prior to (major) surgical interventions, as these also represent a far-reaching stress on the body (endurance stress). It is not a routine application in anesthesia.

The usual procedure before an operation is a six-hour grace period for solid food ( sobriety ). This is to avoid perioperative aspiration . If clear liquids are taken, however, a complete gastric passage within two hours can be assumed.

A carb-loading drink must be high in energy , free of particles, fat and milk and, if the patient is possibly lactose intolerant, also lactose- free. It is given 90 to 120 minutes before induction of anesthesia . A relevant influence on the gastric pH value should not take place.

A reduced perioperative metabolic stress reaction as well as postoperative peripheral insulin resistance and a subjectively increased patient comfort are stated as advantages of the preoperative nutrient supply . Carbo-loading increases the insulin value and inhibits lipolysis , and the concentration of free fatty acids in the blood is lower. There is no known negative influence of preoperative carboloading on postoperative nausea or vomiting (PONV). Close-meshed blood glucose monitoring is essential, both intra- and perioperatively.

literature

O. Ljungqvist et al. a .: Modulation of post-operative insulin resistance by pre-operative carbohydrate loading. In: Proc-Nutr-Soc. 61 (3), 2002, pp. 329-336.
MW Wichmann u. a .: Preoperative sobriety. In: CHAZ. 4th year, 9th issue, 2003.
Guidelines on parenteral and enteral nutrition: surgery. ASPEN
Recommendations for parenteral and enteral nutrition therapy in adults (version 2004) LFS
MG Henriksen u. a .: Effects of preoperative oral carbohydrates and peptides on postoperative endocrine response, mobilization, nutrition and musle function in abdominal surgery. In: Acta Anaesthesiol. Scand. 47, 2003, pp. 191-199.
EJ O'Mullane: Vomiting and regurgitation during anesthesia. In: The Lancet . 263 (6824), 1954, pp. 1209-1212. doi: 10.1016 / S0140-6736 (54) 92444-7
CD Spies u. a .: Preoperative food leave. In: Anaesthesiologist. 52, 2003, pp. 1039-1045.
E. Rant: Preoperative “Carbo-Peptide-Loading”. In: Aktuel Ernahrungsmed. 32, 2007. doi: 10.1055 / s-2007-983418

Individual evidence

^ E. Søreide, LI Eriksson, G. Hirlekar, H. Eriksson, SW Henneberg, R. Sandin, J Raeder; (Task Force on Scandinavian Pre-operative Fasting Guidelines, Clinical Practice Committee Scandinavian Society of Anaesthesiology and Intensive Care Medicine): Pre-operative fasting guidelines: an update. In: Acta Anaesthesiol Scand. 49 (8), 2005, pp. 1041-1047. Review. PMID 16095440 .
↑ Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: a report by the American Society of Anesthesiologist Task Force on Preoperative Fasting. In: Anesthesiology. 90 (3), 1999, pp. 896-905. PMID 10078693 .
↑ MG Henriksen, I. Hessov, F. Dela, HV Hansen, V. Haraldsted, SA Rodt: Effects of preoperative oral carbohydrates and peptides on postoperative endocrine response, mobilization, nutrition and muscle function in abdominal surgery. In: Acta Anaesthesiol Scand. 47 (2), 2003, pp. 191-199. PMID 12631049 .

[1] E. Søreide, LI Eriksson, G. Hirlekar, H. Eriksson, SW Henneberg, R. Sandin, J Raeder; (Task Force on Scandinavian Pre-operative Fasting Guidelines, Clinical Practice Committee Scandinavian Society of Anaesthesiology and Intensive Care Medicine): Pre-operative fasting guidelines: an update. In: Acta Anaesthesiol Scand. 49 (8), 2005, pp. 1041-1047. Review. PMID 16095440 .

[2] Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: a report by the American Society of Anesthesiologist Task Force on Preoperative Fasting. In: Anesthesiology. 90 (3), 1999, pp. 896-905. PMID 10078693 .

[3] MG Henriksen, I. Hessov, F. Dela, HV Hansen, V. Haraldsted, SA Rodt: Effects of preoperative oral carbohydrates and peptides on postoperative endocrine response, mobilization, nutrition and muscle function in abdominal surgery. In: Acta Anaesthesiol Scand. 47 (2), 2003, pp. 191-199. PMID 12631049 .