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Preparing Your Patients for Surgery with the ClearFast Enhanced Recovery Drink: Your Top 5 Questions Answered

With traditional NPO on its way out and pre-surgery carbohydrate loading taking its place, we’re now on the forefront of a major shift in the way the medical industry looks at surgery prep. This shift means that our team often gets asked a number of great questions about safely preparing patients for surgery with our enhanced recovery drink. We understand that, as medical professionals, your number-one goal is to ensure safe and effective surgical outcomes and overall patient satisfaction—which is why, today, we wanted to take some time to answer the top five questions we hear from physicians and healthcare centers. Read on for answers to our most common medical-pro FAQs.

1. We’ve always done NPO. Why should I be ClearFasting my patients now?

More and more medical research is pointing to the fact that pre-op carbohydrate loading with a clear, complex carb-rich beverage leads to safer procedures and greater patient satisfaction. There are a number of science-backed reasons you should consider replacing NPO with fasting with an enhanced recovery drink instead, including:

• Fluid Fasting Leads to Lower Stomach Acidity: The purpose of NPO is ultimately to reduce a patient’s risk of aspiration. Recent medical studies have found, however, that fluid fasting in place of NPO works to raise the pH in a patient’s stomach, leading to lower gastric acids and, ultimately, a reduced risk of aspiration under anesthesia. (You can read more about lowering stomach acidity and increasing patient safety with fluid fasting here.)

• Evidence-Based vs Non-Evidence Based: It’s important to keep in mind that NPO was never an evidence-based practice. Enhanced Recovery After Surgery Programs (ERAS®), evidence-based programs borrowed from Europe and the UK, are becoming increasingly popular in luminary hospitals across the United States. These programs are comprised of 17 key elements for perioperative patient management, which, when combined, work to ensure a better surgical outcomes, enhanced recovery after surgery and increased patient satisfaction overall. One of the most important of the 17 elements is preoperative carbohydrate loading using a compliant ERAS® drink like ClearFast in place of NPO. (You can read more about choosing the right ERAS® drink for better surgical outcomes here.)

• Higher Patient Satisfaction, Reduced PONV, Shorter Hospital Stays: In a large controlled study, patients in the pre-op area who drank ClearFast were 5.5-6.5 times more likely to describe themselves as “comfortable” than their cohorts who underwent traditional fasting from midnight. In addition to creating a more comfortable pre-surgery experience for patients, fluid fasting with the ClearFast enhanced recovery drink reduces a patient’s risk of PONV, ultimately decreasing the length of hospital stay.

2. Can my diabetic patients have ClearFast?

Any medical pro knows that preparing a diabetic for surgery is far more nuanced than preparing a healthy patient for surgery. Pre-op carb-loading for diabetics is actually one of the safest, most effective ways to manage blood sugar levels before, during and after surgery—which results in a number of benefits, including:

• It reduces a diabetic patient’s risk of pre-op complications: Diabetic patients are often the most adversely affected by prolonged fasting, as a prolonged fast can ultimately send their body into a catabolic state—which, for a diabetic, can lead to serious complications like hyperglycemia and even ketoacidosis. Rather than ignoring a diabetic’s unique dietary needs as traditional NPO does, a fluid fast with the ClearFast enhanced recovery drink works with a diabetic’s dietary needs, ultimately protecting their critical glycogen stores.

• It reduces a diabetic patient’s risk of postoperative insulin resistance (PIR): Numerous studies have found that pre-op carb-loading with a complex carb-rich, clear preop drink like ClearFast can reduce a diabetic’s risk of post-op insulin resistance and post-op infections, as well as reduce the occurrence of PONV—all of which make managing blood-sugar difficult, posing particular danger for those with diabetes. (You can read more about preparing your diabetic patients for surgery with ClearFast here.)

3. What about patients with gastroparesis or GERD?

We typically recommend patients finish their last bottle of ClearFast two hours prior to their surgery time; however we’ve modified these recommendations for those with delayed gastric emptying so as to avoid the risk of aspiration. Instead of a final dose completed two hours before surgery, we recommend you push the final dose to four hours before surgery. Again, as a physician, you always have the best, most informed guidance for your individual patient’s gastric emptying times.

4. Can my pediatric patients use the ClearFast enhanced recovery drink?

Absolutely! Pediatric patients are often the hardest to fast, which is why ClearFast is such a great option to keep them happy, hydrated and nourished before surgery. A pediatric patient’s dosing, of course, will differ from that of an adult’s depending on their weight and age. Take a look at our ClearFast Pediatric Dosing Chart for specific dosage recommendations to determine the best way to prep your pediatric patients for surgery with the ClearFast enhanced recovery drink.

5. You talk a lot about infection rates. How can ClearFast help with that?

NPO induces a catabolic state wherein the normal relationship between insulin and glucose are uncoupled. To compensate for the lack of “fuel” brought on by fasting, the body uses up its critical glycogen stores and then begins to breakdown fat and muscle as alternative energy sources. Insulin levels rise in response to rising glucose levels, but target cells (including muscle) fail to respond to it. In effect, patients become insulin-resistant. When patients are insulin-resistant after surgery and have a fresh surgical incision, the chance for infection greatly increases, as the “sweet environment” invites microbial colonization.  Fluid fasting with the ClearFast enhanced recovery drink, on the other hand, effectively protects or spares critical glycogen stores in the immediate pre-op window and stabilizes blood sugars—reducing a patient’s risk of hyperglycemia and any associated infection. Ultimately, by reducing a patient’s risk of postoperative insulin resistance or PIR, ClearFast helps to reduce the risk of surgical infection.

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Have we answered all of your questions? We hope so! If you’re ready to improve outcomes for your patients and your hospital, you can order your ClearFast Preop Drink here. Or, reach out to the ClearFast team at support@drinkcf.com if you have any questions at all. We’re always here and happy to help!

Liquid Fasting for Orthopedics Patients, Diabetics and More: The Unique Benefits of ClearFast for Different Types of Surgery

Fluid fasting before surgery offers a number of valuable benefits for patients across the board—like reduced post-op nausea and vomiting, and a less stressful surgery experience—but today we wanted to break down the specific benefits of fluid fasting as they apply to different service lines. From liquid fasting for orthopedics patients to liquid fasting for diabetics, preparing for surgery with a complex carb-rich preop drink like ClearFast provides a distinct set of benefits for different types of procedures. Today, we’ll cover:

• How ClearFast reduces an orthopedics patient’s risk of infection

• How ClearFast makes for safer surgeries for diabetics

• How ClearFast helps to hydrate and nourish dehydrated colorectal & colonoscopy patients

Now, let’s dig in…

Liquid Fasting for Orthopedics Patients

The unique problem: Increased risk of Infection

Fasting from midnight, which was never evidence-based, induces a catabolic state where the normal relationship between insulin and glucose are uncoupled. To compensate for the lack of “fuel” brought on by fasting, the body uses up its critical glycogen stores and then begins to breakdown fat and muscle as alternative energy sources. Insulin levels rise in response to rising glucose levels, but target cells (including muscle) fail to respond to it. In effect, patients become insulin resistant.

Following surgery, this post-op insulin resistance (PIR) can translate into hyperglycemia, which increases the chance of surgical site infections, as the “sweet environment” invites microbial colonization. Orthopedic patients are at an especially high risk of surgical site infection and joint infections because of the added vulnerability of blood supply to injured or surgically manipulated bones and joints—in addition to the inherent risk associated with implantation technology. The two main potential infection sites are broken bones and the area of surgical incision.

The solution ClearFast provides: Reduced risk of Hyperglycemia and Infection

Liquid fasting for orthopedics patients assures nutrition, hydration and maintenance of electrolytes. It effectively protects or spares critical glycogen stores. Nourishing orthopedic patients with a preop drink like ClearFast in the immediate pre-op window will stabilize blood sugars—ultimately reducing a patient’s risk of hyperglycemia and any associated infection.

Liquid Fasting for Diabetics

The unique problem: Starving a diabetic patient before surgery is extremely dangerous

A prolonged fast ultimately sends a patient’s body into a catabolic state (the body uses up its glycogen stores when it needs energy before surgery and then moves on to breaking down healthy fat and muscle tissue as an alternative energy source). This isn’t ideal for the average healthy patient—let alone for someone managing diabetes. For diabetics, this catabolic state can lead to serious complications—like a diabetic arriving in preop with complications like hyperglycemia and even ketoacidosis. In essence, a prolonged fast before surgery completely ignores—rather than works with—a diabetics’ unique dietary needs, which creates an extremely dangerous environment for surgery. (You can read more about preparing for surgery with diabetes here.)

The solution ClearFast provides: Effectively manages blood sugar levels before, during, and after surgery

Preparing diabetics for surgery with the complex carbs they need for energy helps to ensure their body isn’t using up all of those ever-important glycogen stores. This ultimately helps a diabetic proactively manage his or her blood-sugar levels (rather than being at the mercy of the “from midnight” fast)—reducing their risk of dangerous conditions like pre-op hyperglycemia and ketoacidosis and post-op insulin resistance.

Liquid Fasting for Colorectal/Colonoscopies

The unique problem: Extreme dehydration before surgery + foul-tasting prep liquid

Colonoscopies are one of the most common procedures in the U.S.—and preparing for one is a unique challenge for patients. A pre-op fast from midnight starves and dehydrates every patient, but colonoscopy patients are especially taxed due to the stressful effects of colonoscopy prep. With a prep routine that flushes fluid from the body, patients lose nearly all electrolytes—which is extremely dehydrating and dangerous. Add in the fact that the colonoscopy prep liquid tastes terrible, and you’ve got a recipe for an unnecessarily negative and stressful patient experience.

The solution ClearFast provides: Medical-grade hydration for colonoscopy patients and an easy way to drink the prep-liquid

Clear, colorless and chock-full of complex carbs (as opposed to dyed sports drinks that contain simple sugars), the ClearFast preop drink is a safe solution for properly hydrating and nourishing colorectal and colonoscopy patients. Drinking ClearFast before surgery—especially for colorectal patients undergoing unpleasant prep—assures partial restoration of electrolytes. Easy to drink and delicious when chilled, ClearFast is also a great option for patients struggling to drink the foul-tasting colonoscopy prep liquid, as they can “chase” the prep liquid with the better tasting ClearFast preop drink. Plus, drinking ClearFast before a colonoscopy increases comfort before the procedure and reduces a patient’s risk of post-op nausea and vomiting after their procedure.

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Overall, whether it’s liquid fasting for orthopedics patients, diabetics or colorectal/colonoscopy patients, preparing patients with a complex carb-rich preop beverage like ClearFast can successfully address each of the unique challenges and inherent risks associated with a number of procedures across an array of medical fields. Whether you’re a patient looking to properly nourish and hydrate before surgery, or a medical provider seeking safer surgeries and better surgical outcomes, you can order your ClearFast Preop Drink here to help you achieve surgery success! And, as always, reach out to the ClearFast team at support@drinkcf.com if you have any questions about our preop drink at all.