DYNAMICS OF PHOSPHATE LEVEL AND ADAPTATION POTENTIAL IN THE IMPLEMENTATION OF THE ERAS-PROTOCOL IN OVERWEIGHT PATIENTS WITH A SURGICAL PROFILE
Abstract
The results of the treatment of overweight patients under the ERAS program are presented. When comparing different variants of the intensive care protocol, it is best to add colecalciferol and D-fructose-1,6-diphosphate sodium salt hydrate.
An increase in the amount of secretory active adipose tissue in the body is accompanied by a decrease in the bioavailability of vitamin D, a decrease in the level of 25 (OH) D in the blood increases the level of parathyroid hormone. The introduction of a planned surgical profile in overweight patients at the screening stage 10 days before surgery to determine the level of 25 (OH) D in the blood is a key point in deciding the possibility of a perioperative period under the ERAS program. Additional use to its classic protocol of colecalciferol (positive effect on long-term effects and is significant in the prediction process) and sodium D-fructose-1,6-diphosphate hydrate solution (directly affects the effect of rapid recovery after elective surgery) improves the quality of motor activity of patients after operations, increases their adaptive capacity by restoring lost muscle function. The optimized classical algorithm of the ERAS program significantly (p <0.05) improved the quality of life in the long run (30 days after surgery), such as physical functioning, general health, viability scale, mental health (SF-36 scale) and reduced body mass index.
References
Vanlint, S. (2013). Vitamin D and obesity. Nutrients, 5(3), 949-56. doi: 10.3390/nu5030949. PMID: 23519290; PMCID: PMC3705328.
Quarles, L. D. (2012). Role of FGF23 in vitamin D and phosphate metabolism: implications in chronic kidney disease. Exp Cell Res, 318(9), 1040104-8. doi: 10.1016/j.yexcr.2012.02.027. PMID: 22421513; PMCID: PMC3336874.
Nazare, J. A., Smith, J., Borel, A. L., Aschner, P., Barter, P., Van Gaal, L., et al. (2015). Usefulness of measuring both body mass index and waist circumference for the estimation of visceral adiposity and related cardiometabolic risk profile. Am J Cardiol, 115, 307–315.
Migliaccio, S., Di Nisio, A., Mele, C., Scappaticcio, L., Savastano, S., Colao, A. (2019). Obesity Programs of nutrition, Education, Research and Assessment (OPERA) Group. Obesity and hypovitaminosis D: causality or casualty? Int J Obes Suppl, 9(1), 20-31. doi: 10.1038/s41367-019-0010-8. PMID: 31391922; PMCID: PMC6683181.
Dzik, K. P., Kaczor, J. J. (2019). Mechanisms of vitamin D on skeletal muscle function: oxidative stress, energy metabolism and anabolic state. Eur J Appl Physio, 119(4), 825-839. doi: 10.1007/s00421-019-04104-x.
Picard, M., McEwen, B. S., Epel, E. S., Sandi, C. (2018) An energetic view of stress: Focus on mitochondria. Front Neuroendocrinol, 49, 72-85. doi: 10.1016/j.yfrne.2018.01.001. Epub 2018 Jan 12. PMID: 29339091; PMCID: PMC5964020.
Silva Filho, A. L., Santiago, A. E., Derchain, S. F., Carvalho, J. P. (2018). Enhanced Recovery After Surgery (ERAS): New Concepts in the Perioperative Management of Gynecologic Surgery. Rev Bras Ginecol Obstet, 40(8), 433-436. doi: 10.1055/s-0038-1668581.
Gustafsson, U.O., Scott, M.J., Hubner, M., Nygren, J., Demartines, N., Francis, N. (2019). Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: 2018. World J Surg, 43(3), 659-695. doi: 10.1007/s00268-018-4844-y. PMID: 30426190.
Kim, J.Y., Wie, G.A., Cho, Y.A., Kim, S.Y., Sohn, D.K., Kim, S.K. (2018). Diet Modification Based on the Enhanced Recovery After Surgery Program (ERAS) in Patients Undergoing Laparoscopic Colorectal Resection. Clin Nutr Res, 7(4), 297-302. doi: 10.7762/cnr.2018.7.4.297. PMID: 30406059; PMCID: PMC6209732.
Lee, J.Y., Imel, E.A. (2013). The changing face of hypophosphatemic disorders in the FGF-23 era. Pediatr Endocrinol Rev,10(2), 367-79. PMID: 23858620; PMCID: PMC4170520.
Zhao, Y., Li, Z., Shi, Y., Cao, G., Meng, F., Zhu, W. (2016). Effect of hypophosphatemia on the withdrawal of mechanical ventilation in patients with acute exacerbations of chronic obstructive pulmonary disease. Biomed Rep, 4(4), 413-416. doi: 10.3892/br.2016.605. PMID: 27073623; PMCID: PMC4812158.
Kanis, J., Mccloskey, E., Johansson, H. (2013). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int, 24(1), 23-57. doi: 10.1007/S00198-012-2074-y.
Baevsky, R.M., Berseneva, A.P. (1993). Pre-nosological diagnostics in health state evaluation. Valeologiya, p. 131. [in Russian].
Views:
166
Downloads:
163
Copyright (c) 2020 Dyachenko Hlib Dmytrovych, Volkova Yuliya
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
