Impact of preoperative fasting time on acid-base balance and blood glucose concentration in adults

Yu.O. Svitlyk, M.O. Harbar, H.V. Svitlyk

Abstract


Background. The duration of preoperative food and clear liquid limitation is often longer than the recommended one, which may affect the blood gas balance and the level of glycemia before surgery. The article deals with the key points of the guidelines of the European Society of Anesthesiology and the American Society of Anesthesiologists regarding the safe time of preope­rative fasting in adults and children. The purpose of our study was to analyse acid-base balance and blood glucose concentration in adult patients before induction of anesthesia taking into account the time of preoperative food and fluid intake. Materials and method. The study included 12 patients with median age of 44.33 ± 8.14 years, who underwent elective non-cardiac surgery. Before induction of anesthesia, a blood sample was taken to determine the glucose concentration, pH, HCO3– bicarbonate, base excess or deficit and pCO2. Results. The average fasting time was 15.96 ± 1.03 hours that exceeded the recommended one by 2.66 times. No patient was drinking clear liquids within two hours before anesthesia induction. The average blood glucose level was 4.73 ± 1.13 (3.0 to 6.1) mmol · l–1. One person (woman, 20 years old) had blood glucose level 3.0 mmol · l–1 without signs of hypoglycemia; the time of fasting was 16.5 hours. The average value of pH in all examined individuals was 7.35 ± 0.04 (from 7.28 to 7.4). In all patients (except one) we observed base deficit: mean value of buffer capacity was –2.08 ± 2.45 (from –5.5 to 0.4). The average value of HCO3– was 24.08 ± 3.13 (20.5 to 27.8) mmol · l–1. Correlation analysis revealed a strong inverse correlation between the increase in fasting time and the pH (r = –0.79, p = 0.06). Conclusions. Prolongation of the fasting time before surgery is associated with the metabolic acidosis onset and the development of hypoglycemia.


Keywords


preoperative fasting; acid-base state; glycemic level; recommendations

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DOI: https://doi.org/10.22141/2224-0586.3.90.2018.129488

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