Evidence map›Paper›PMID 40450020›Full record

SynthesisScientific reports2025

Preoperative carbohydrate loading reduces length of stay after major elective, non-cardiac surgery when compared to fasting: a systematic review and meta-analysis.

Anna Réka Sebestyén, Caner Turan, Ambrus Szemere, Marcell Virág, Klementina Ocskay, Fanni Dembrovszky, László Szabó, Péter Hegyi, Marie Anne Engh, Zsolt Molnár

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Anna Réka Sebestyén *Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Üllői út 26, Hungary.
Caner Turan *Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Üllői út 26, Hungary.
Ambrus SzemereCentre for Translational Medicine, Semmelweis University, Budapest, 1085, Üllői út 26, Hungary.
Marcell VirágSzent György University Teaching Hospital of Fejér County, Székesfehérvár, Budapest, Hungary.
Klementina OcskayHeim Pál National Pediatric Institute, Budapest, Hungary.
Fanni DembrovszkyCentre for Translational Medicine, Semmelweis University, Budapest, 1085, Üllői út 26, Hungary.
László SzabóCentre for Translational Medicine, Semmelweis University, Budapest, 1085, Üllői út 26, Hungary.
Péter HegyiCentre for Translational Medicine, Semmelweis University, Budapest, 1085, Üllői út 26, Hungary.
Marie Anne Engh *Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Üllői út 26, Hungary.
Zsolt Molnár *Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Üllői út 26, Hungary. zsoltmolna@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Preoperative fasting is a worldwide routine even though the most recent Enhanced Recovery After Surgery (ERAS) Guidelines recommend preoperative carbohydrate loading instead of fasting, but with low quality of evidence. Our aim was to compare the effects of preoperative carbohydrate loading to fasting and placebo in patients undergoing elective major non-cardiac surgery under general anaesthesia. Our systematic search was conducted on 15th of October 2021 in five databases, Medline, Embase, Central, Web of Science and Scopus, and updated on November 12th, 2024. We included randomized controlled trials that compared the carbohydrate loading (CHO-group) with fasting or with placebo. Main outcomes were length of hospital stay (LOS), postoperative glucose levels on postoperative, postoperative insulin levels, and C-reactive protein (CRP) levels. Our search revealed 44 eligible articles for data extraction. LOS was shorter in the CHO group as compared to the No-CHO group (MD: - 0.56 [95% CI: - 1.10, - 0.02]). There were no clinically significant differences between the CHO and No-CHO groups regarding the postoperative glucose, insulin and CRP levels. This meta-analysis found that preoperative CHO-loading as compared to preoperative fasting or placebo shortened the length of hospital stay in patients undergoing major elective, non-cardiac surgery. Although several details are still to be unveiled, these data provide further support that preoperative carbohydrate loading could be beneficial in this patient population.

Indexed as

Diet, Carbohydrate LoadingElective Surgical ProceduresFastingLength of StayPreoperative CareBlood GlucoseC-Reactive ProteinHumansInsulinRandomized Controlled Trials as TopicBlood GlucoseC-Reactive ProteinInsulinLength of stayMajor surgeryNon-cardiac surgeryOral carbohydrate loadingPreoperative fasting

Identifiers

PMID40450020
PMCPMC12126546

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.