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Journal of Parenteral and Enteral Nutrition
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Original Communications

Carbohydrate Supplementation Before Operation Retains Intestinal Barrier Function and Lowers Bacterial Translocation in a Rat Model of Major Abdominal Surgery

Hetty Bouritius, MSc1, Danny C. van Hoorn, PhD1, Annemarie Oosting, MSc1, Mariska C. van Middelaar-Voskuilen, MD1, Cees J. P. van Limpt, MD1, Kelly J. Lamb, MSc1, Paul A. M. van Leeuwen, MD, PhD2, Aldwin J. M. Vriesema, PhD1 and Klaske van Norren, PhD1

From 1 Numico Research B.V., Wageningen, and2 Free University Medical Center, Amsterdam, The Netherlands.

Address correspondence to: Klaske van Norren, PhD, Numico Research B.V., PO Box 7005, 6704 PH Wageningen, The Netherlands; e-mail: klaske.vannorren{at}numico-research.nl.

Background: Overnight fasting of rats augments the susceptibility of the small intestine to ischemia–reperfusion damage. Feeding before surgery may improve injuries to distant organs that were induced by ischemia–reperfusion. The present study tested the hypothesis that one of the food constituents, namely carbohydrates, may be responsible for the protective effect of preoperative feeding on postoperative organ dysfunction. Methods: Male Wistar rats were fed ad libitum for 5 d and had either free access to water or free access to a carbohydrate drink and water. Then they were fasted for 16 h and access remained to either water or a carbohydrate drink and water. Following this, the arteria mesenterica superior was clamped for 60 min followed by 180 min of reperfusion. Subsequently, the intestinal permeability of stripped ileum was determined by measuring the mucosal to serosal flux in Ussing chambers. For assessment of bacterial content, organs were aseptically removed and assessed for bacterial content by culture under anaerobic conditions. Results: Preoperative supplementation with carbohydrates resulted in a better maintenance of intestinal barrier function when compared with water supplemented animals. Moreover, carbohydrate supplementation resulted in a reduction in the ischemiareperfusion–induced increase in bacterial content of the liver, kidney, and mesenteric lymph nodes. Conclusions: Preoperative intake of carbohydrates by rats retains both the intestinal barrier function and prevents translocation of bacteria to distant organs.

Key Words: Preoperative carbohydrates supplementation • bacterial translocation • intestinal permeability • gut health • perioperative nutrition

Journal of Parenteral and Enteral Nutrition, Vol. 32, No. 3, 247-253 (2008)
DOI: 10.1177/0148607108316191
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