Abreviação de jejum em indivíduos submetidos à cirurgia cardíaca: uma revisão integrativa

Abstract

ABSTRACT Introduction: Cardiac surgeries are one of the therapeutic alternatives aimed at treating cardiovascular diseases (CVD), with preoperative fasting time being one of the factors associated with metabolic and clinical losses related to unfavorable postoperative outcomes. Objective: to carry out a review of the literature on the topic of shortening fasting in individuals undergoing cardiac surgery, as well as describing the strategies used and main associated clinical outcomes. Methodology: this is an integrative review, carried out using the data sources: Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica DataBASE (EMBASE), Latin American and Caribbean Literature in Health Sciences (LILACS) and Google Scholar. The following guiding question was considered “What are the most used preoperative fasting abbreviation strategies, as well as the main clinical outcomes associated with individuals undergoing cardiac surgery?”. Search keys were defined for each database, considering the main keywords: “Operative Procedures”, “Procedure, Cardiac Surgical”, “preoperative fasting” and “carbohydrate”. The Rayyan® tool was used to screen and select articles. Results: 07 studies were included, covering a total number of 937 individuals, the majority of whom were male. Myocardial revascularization or valve replacement were the most predominant cardiac procedures. Among the studies evaluated, 57.1% indicated a fasting time of around 2 to 3 hours before heart surgery. It was evident that in 42.8% of the studies an oral carbohydrate solution was used - maltodextrin 12.5%. Three randomized clinical trials associated carbohydrates with other nutrients (proteins, lipid emulsions, omega 3 and vitamin E). The main clinical outcomes identified were better glycemic control, reduction in the amount of insulin in the immediate postoperative period, length of stay in the intensive care unit, use of inotropic drugs, dry mouth and hunger. Conclusion: The strategies addressed based on oral maltodextrin carbohydrate solution 12,5% were predominant among the studies and safe in terms of clinical outcomes, helping in the optimized recovery of individuals after cardiac surgery.