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Featured Posts For Med Pros Preparing for Surgery Presurgery Nutrition

What is ERAS®?

     ERAS® stands for Enhanced Recovery After Surgery. In the 1990s, Professor Henrik Kehlet founded Enhanced Recovery After Surgery (ERAS®), specifically in colorectal surgeries. There is now available research on ERAS in colorectal, vascular, thoracic, urosurgery, spine, neurosurgery, orthopedic, liver, pancreatic, and cardiac surgery. In the early 2000’s an ERAS society was formed that dedicated time to research preoperative care to improve recovery after surgery. The ERAS® society discovered that some traditional practices were no longer the best practice through evidence-based research. Since then, ERAS has gained much more consideration because of its overall advantageous effect on recovery after surgery, increased patient comfort, psychological well-being, decreased complications post-surgery, and reduced length of stay (LOS). 

What are the main pillars of ERAS®?

      The main ERAS® principles include protocols for preoperative, intraoperative, and postoperative care. All ERAS® protocols aim to lessen the body’s response to surgical trauma and maintain normal physiological function during surgery. 

ERAS® preoperative principles include:

  • pre admission counseling
  • fluid and carbohydrate loading
  • removing prolonged fasting
  • no/selective bowel preparation
  • antibiotic prophylaxis
  • thromboprophylaxis
  • no premedication

ERAS® intraoperative protocols include:

  • short-acting anesthetic agents
  • no drains
  • mid-thoracic epidural anesthesia
  • avoidance of salt and water overload
  • maintenance of normothermia

ERAS® postoperative protocols include:

  •  mid-thoracic epidural anesthesia
  • no nasogastric tubes
  • prevention of nausea and vomiting
  • avoidance of salt and water overload
  • early removal of the catheter
  • early oral nutrition
  • non-opioid oral analgesia NSAID
  • early mobilization
  • stimulation of gut motility
  • an audit of compliance and outcomes

What is the goal of ERAS® protocols? 

       As mentioned before, the goal of ERAS® protocols is to reduce the stress response of surgery. When the body undergoes surgical trauma, it can result in a metabolic state of stress. When the body is in this catabolic state, recovery will be slower, and complications are more likely to occur. Some complications associated with this exaggerated stress response are pain, paralytic ileus, increased cardiac demand, respiratory difficulties, increased insulin resistance, and increased infections. These complications lead to delayed recovery post-surgery. By lessening the body’s response to stress, ERAS® protocols help achieve early recovery and decrease LOS. Increased LOS and increased complications post-surgery is a significant issue for many medical professionals. ERAS® is beneficial to both the hospitals due to decreased LOS and costs and the patient as it increases patients comfort, reduces anxiety, and leads to faster recovery. 

Nutrition’s Role in ERAS®

    Nutritional status is critical before surgery. Ideally, a nutritional assessment is done before any surgery to reduce the risk of postoperative complications, increased length of stay, and infection risk. A patient can be diagnosed with mild or severe malnutrition by the MD. A Registered Dietitian assesses the patient for mild to severe malnutrition. The following criteria from Academy Adult Malnutrition Criteria (ASPEN) help to identify moderate malnutrition. A patient must have at least two of following to be diagnosed with moderate malnutrition: weight loss >2% in 1 week, >5% in one month, or >7.5% in 3 months; Energy intake less than or equal to 50% compared to estimated needs for greater than or equal to 5 days; Moderate body fat depletion; Moderate muscle mass depletion; Moderate to Severe Fluid Accumulation; and reduced grip strength. Furthermore, a patient must have at least two of the following to be diagnosed with severe malnutrition: Weight loss 1-2% in 1 week, 5% in one most, 7.5% in 3 months; Energy intake <75% compared to estimated needs in 7 days; mild body fat depletion; mild muscle mass depletion; Mild fluid accumulation; and Reduced grip strength. 

How to correct malnutrition before surgery?

If you need to correct malnutrition before surgery, using CF(Protein)® is a great way to build muscle and strength for a speedy recovery. Other ways to improve nutritional status can include enteral or parenteral nutrition. Obese patients may need to lose excess weight before surgery.

Why should you use CF(Preop)® over the NPO approach?

     Before ERAS® protocols, the traditional approach to surgery was to fast after midnight before surgery to decrease aspiration risk. In the 1990s, evidence-based research suggested that this was not necessary. Furthermore, there are detrimental effects caused by this period of prolonged fasting. Prolonged fasting worsens the catabolic state, increases metabolic stress, hyperglycemia, and insulin resistance. Furthermore, when the body fasts for a lengthy time, glycogen stores are depleted, leading to protein and muscle breakdown. Postoperative insulin resistance (PIR), a result of the stress response from surgery and further exaggerated with prolonged fasting, is directly related to delayed wound healing, increased morbidity/mortality, and LOS. PIR must decrease to enhance recovery after surgery.

Preoperative carbohydrate loading maximizes glycogen stores in the body as an energy source to minimize body tissues’ degeneration and reduce insulin resistance. By changing the metabolic state by shortening preoperative fasting (aka providing a complex carbohydrate 2-3 hours before surgery), PIR will decrease, protein loss reduces, and muscle function will improve. Additionally, preoperative carbohydrate loading increases patients’ comfort and reduces hunger, thirst, and anxiety, leading to surgery, all decreasing stress entering surgery. 

Specific Amounts of Nutrients Needed to Support Enhanced Recovery

CF(Preop)®  is a clear, colorless drink specifically formulated by an anesthesiologist for safe consumption hours before surgery. Each of its premium ingredients promote the highest level of pre surgery safety, comfort, and nourishment. It is designed to lower the risk of surgical site infections, reduce post-op recovery time, minimize post-op complication risk, and promote comfort and minimize stress. 

CF(Preop)®  is formulated for surgery and has all the ASA requirements to make it safe for consumption before your surgery. These requirements include a low osmolarity of 270mOsm to promote gastric emptying. It is clear and colorless and has no fat or protein and contains 50g CHO to shift the body from a fasted to fed state and promote enhanced recovery. It contains maltodextrin to help replenish glycogen depletion by catabolism related to fasting and surgery. Choosing to drink CF(Preop)® before your surgery helps you feel back to normal as soon as possible. 

Now that you know everything about ERAS® and how to prepare for surgery, visit our website to learn more. 

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Featured Posts For Med Pros Preparing for Surgery

CF(Preop)® Before Surgery

Is CF(Preop)® safe before surgery?

Yes, CF(Preop)® is safe before surgery. CF(Preop)® was designed to be a pre-surgical drink. When you order CF(Preop)® you will be sent two bottles. One to be taken the night before your procedure, and one to be taken up to two hours prior to your surgery.

Since 1999 (and republished in 2011 & 2017) the American Society of Anesthesiologists guidelines on preoperative fasting have dictated that it is safe for healthy patients to have clear liquids up to 2 hours before surgery.

Click here to see the latest guidelines from the American Society for Anesthesiologists. 

Why was NPO even started?

Before Enhanced Recovery After Surgery (ERAS®) protocols were discovered, the traditional approach was to fast after midnight prior to surgery to decrease the risk for aspiration. In the 1990’s, evidence-based research suggested that this was not necessary. Furthermore, there are detrimental effects caused by this period of prolonged fasting. Prolonged fasting worsens the catabolic state, increases metabolic stress, hyperglycemia and insulin resistance. Furthermore, when the body is fasted for a prolonged time, glycogen stores are depleted which can lead to protein and muscle breakdown. Postoperative insulin resistance (PIR), a result of the stress response from surgery and further exaggerated with prolonged fasting, is directly related to delayed wound healing, increased morbidity/mortality and length of stay. 

Why is CF(Preop)® consumed up to 2 hours before surgery?

It takes approximately 90 minutes for the oral carbohydrate solution to pass the stomach. Solid foods can be ingested up to 6 hours prior to surgery. The amount of carbohydrate to induce an effect must be enough to shift the body from a fasted to a fed state (50g carbohydrate 2 hours prior to surgery). There is no protein or fat in CF(Preop)® in order for it to safely empty your stomach before surgery. 

If you or your patient have delayed gastric emptying due to an underlying condition,  CF(Preop)®  should be consumed 3-4 hours before the procedure. 

How can I be sure that CF(Preop)® is out of my system in time?

Low osmolarity 240mosmol/l solution is also recommended to promote effective gastric emptying and dispel concerns for gastric emptying. CF(Preop)® meets this requirement. The recommended approach is to provide a carbohydrate drink with complex carbohydrates 800mL at bedtime and 400mL 2 hours prior to any procedure. The drink should contain 12.5% maltodextrin to allow for complete gastric emptying prior to surgery. CF(Preop)® meets this requirement as well so there is no concern for delayed gastric emptying.

What are the benefits of CF(Preop)®?

To enhance recovery after surgery, it is important to decrease PIR. Preoperative carbohydrate loading maximizes glycogen stores in the body as an energy source in order to minimize degeneration of body tissues and reduce insulin resistance. By changing the metabolic state, by shortening preoperative fasting (aka providing a complex carbohydrate 2-3 hours prior to surgery like CF(Preop)®, PIR will be decreased, protein loss will be reduced, and muscle function will improve. Additionally, preoperative carbohydrate loading increases patients comfort and reduces hunger, thirst, and anxiety, all decreasing stress entering surgery. In conclusion, consuming CF(Preop)®before your procedure is not only safe but also beneficial in your recovery outcomes.

Now you know everything you need to know about CF(Preop)® and why it is so important to consume before surgery.

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Featured Posts For Med Pros Healthy Lifestyle

Fiber’s Role in Our Diet

Fiber is a crucial component of the diet, yet many of us don’t reach the Recommended Daily Allowance (RDA). Today we break down how much is recommended and how to incorporate it into your diet. Plus we discuss how CF(Protein)® can help us meet the RDA.

 What is fiber?

Fiber is a type of carbohydrate that the body cannot digest. It helps regulate bowel movements, keep blood glucose levels in the normal range, and helps increase satiety which can support weight management. There are two different types of dietary fiber – soluble and insoluble. Insoluble fiber passes through the body undigested, unlike other carbohydrates. Soluble fiber dissolves in water and may help lower blood glucose and cholesterol. Examples of foods with soluble fiber are oatmeal, nuts, beans, lentils, apples, and blueberries. Insoluble fiber does not dissolve in water and helps food move through your digestive system. Consuming insoluble fiber helps regulate your digestive system and may help prevent constipation. Some examples of insoluble fiber are wheat, whole wheat bread, whole grain couscous, brown rice, legume, carrots, cucumbers, and tomatoes.

How much should I consume each day?  

The 13 grams of fiber per 8-ounce bottle of CF(Protein)® comes from non-GMO soluble vegetable fiber. The RDA for total fiber intake for men and women 19-50 years of age is 38 grams/day and 25 grams/day, respectively. The RDA for men and women over 51 is 31 grams/day and 21 grams/day, respectively. Consuming CF(Protein)® can help you meet the RDA and get all the benefits of consuming adequate amounts of fiber.

How can I include more in my diet?

Most Americans do not consume enough dietary fiber. On average, Americans consume about 15 grams of fiber per day, far lower than the RDA, regardless of age or gender. The best ways to increase fiber intake are choosing whole grains whenever possible, consuming legumes and beans, and increasing fruit and vegetable intake. Drinking CF(Protein)® can help support you in achieving the RDA because it contains 13 grams per one 8 ounce bottle.

Preventing diseases with adequate fiber:

Fiber may help reduce the risk of developing various diseases, including heart disease and diabetes. Studies show that the intake of fiber lowers the risk of developing cardiovascular disease. NHANES cross-sectional Data (2003-2006) showed that intake of whole grains (rich in fiber) was associated with enhancing the effects of statin in lowering cholesterol.

Fiber may help prevent constipation by regulating bowel movements. Constipation is a common gastrointestinal problem that many people experience. If you have chronic constipation, you may need to ramp up your fiber intake, and drinking CF(Protein)® is an easy and effective way to do so. As always, if you have a chronic health issue, it is best to speak to your doctor for any specific recommendations.

Fiber can also help maintain a healthy weight. High fiber foods are typically more filling than lower fiber foods. They also help keep you feeling fuller for longer. Satiety is the term used to describe your fullness. Fiber increases satiety after a meal. If you are looking to lose weight, increasing your fiber intake may help by increasing satiety and preventing the intake of excess calories.   

If you are not getting enough fiber, we recommend drinking one CF(Protein)® a day as a simple yet effective way to reap the benefits of adequate fiber intake.

Now that you know everything about fiber, check our our website to purchase CF(Protein)® to easily meet the RDA.

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Featured Posts For Med Pros Nutrition

What is Ketosis?

The ketogenic diet has become popular over the past few years. As many of us know, a ketogenic diet is a very low carbohydrate and high fat diet. But what is actually going on when you follow a keto diet correctly?  Today on the blog we break down what happens when your body enters ketosis. We will also discuss how many carbohydrates are in each of our products to help you understand which products you can have to remain in ketosis. 

What is ketogenesis?

Ketogenesis is a metabolic pathway that produces ketone bodies and provides an alternative energy source for the body. Your body and brain need glucose to function. When carbohydrates are restricted, and glucose is not available, ketogenesis occurs. It is a metabolic process to help the body survive on low levels of exogenous glucose. 

 In healthy individuals, small amounts of ketones are continually being produced and used in the body as energy. During a prolonged period of fasting, the nervous system can oxidize ketone bodies as an alternate energy source. In ketosis, ketone body production increases when there are decreased carbohydrates or increased fatty acids. 

How many carbohydrates can I have to stay in ketosis?

The number of carbohydrates it will take to “kick you out of ketosis” can vary from person to person. Typically, limiting your carbohydrate intake to under 35g will keep you in ketosis. However, some people may need to restrict their carbohydrate intake to under 20g/day, while others can reach up to 50g/day and stay in ketosis. So, depending on your specific carbohydrate limit, some or all of our products may “kick you out of ketosis.”

How many carbohydrates are in CF Nutrition Products?

CF Nutrition’s products carbohydrate content in grams:

  • CF(PreOp)® – 50 g carbohydrate/bottle
  • CF(Protein)®- 29 g carbohydrate/bottle
  • CF(Rehydrate)® – 10g carbohydrate/serving (3 servings per bottle)
  • CF(Rehydrate)® Immunity+ – 6g carbohydrate/ serving (3 servings per bottle)

What CF Nutrition products can I have to stay in ketosis?

If you are trying to stay in ketosis, we do not recommend CF(PreOp)® or CF(Protein)® as those contain higher amounts of carbohydrates and will likely take you out of ketosis. CF(PreOp)® is a presurgical drink and typically consumed in the hours before surgery. Depending on how many other carbohydrates you are consuming throughout the day, one serving of either CF(Rehydrate)® or CF(Rehydrate)® Immunity+  should keep you in ketosis.  

What is ketoacidosis?

An overproduction of ketone bodies through increased ketogenesis can cause a problem because ketones are acidic. Ketoacidosis occurs when there are too many ketone bodies (occurs in cases of uncontrolled DM). Overproduction of ketone bodies through increased ketogenesis can be detrimental. An example of this is Diabetic Ketoacidosis or DKA. DKA occurs when there is a lack of insulin or insulin resistance and is more common in Type 1 Diabetics. The threshold for DKA is a glucose level of 250 mg/dL.

Should I follow a keto diet?

Following a keto diet has become a very popular way to lose weight. At CF Nutrition, we feel it is important to discuss what type of diet is right for you with your Dietitian or Doctor as everyone is different. Our mission is to provide you with the information you need and separate fact and fiction. 

Now that you know all about ketosis, check out our blog for more information on health and wellness. While you’re at it, head to our https://drinkclearfast.com/ to purchase CF Nutrition products.

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Featured Posts For Med Pros Preparing for Surgery Presurgery Nutrition

How do I use CF(Protein)® to Prepare for Surgery?

Whether you’re trying to preserve muscle mass following a procedure or replenish your body with nutrients after an athletic event, adding protein to your diet is a great way to give your body what it needs to be its best. CF(Protein)® was created for both ease and enjoyment. Thirteen grams of delicious, clean plant protein is packed into an 8-oz bottle that can be enjoyed on-the-go!

What are the benefits of CF(Protein)®?

CF(Protein)® is a plant-based protein drink that provides a concentrated dose of natural electrolytes, antioxidants, and essential fats. CF(Protein)® is a great choice for anyone who is preparing for, or recovering from surgery. Plant protein is the modern way to give your body the best nutrients with the lowest impact on your digestive system.

Some benefits of drinking CF(Protein)® are:

·      Promote muscle maintenance, repair, and recovery

·      Strengthen the immune system

·      Reduce risk of malnourishment

·      Antioxidants & anti-inflammatory ingredients

·      Concentrated nutrition on-the-go

·      Healthy omega-3 and omega-6 fats

·      Naturally derived vitamins & minerals

·      Essential amino acids

·      Natural fiber sources

·      No artificial colors or flavors

·      Shelf-stable

·      Gluten-Free, Kosher, Vegan, Dairy-Free

·      Convenient on-the-go protein source

How much CF(Protein)® should I drink leading up to surgery?

Each CF(Protein)® has 13 g of protein per bottle. So, depending on what else you are eating and drinking, and your specific protein needs, consuming 1 to 2 CF(Protein)® drinks per day can help ensure you are optimizing your nutrition prior to surgery. Prior to surgery, drinking 1-2 bottles per day (in addition to a well-balanced diet) for at least 2 weeks prior to surgery, will help you to feel strong and well-nourished for your operation. CF(Protein)® is not designed to be a sole source of nutrition. Therefore, consuming whole foods high in protein, is recommended before and after surgery in order to meet your protein and calorie needs.

What else is in CF(Protein)® other than protein?  

In addition to the protein content in CF(Protein)®, it also contains chia seed oil and turmeric which are anti-inflammatory. These will also help to ensure you are at optimal nutrition status for your surgery as well as strengthen your immune system. The antioxidants in CF(Protein)® will help you to fight off diseases and strengthen your immunity.

How do I determine my protein needs before surgery?  

There are a variety of factors that determine your specific protein needs. These include your age, activity level, chronic diseases, weight, and fitness goals. Typically, someone who is preparing for, or recovering from surgery has increased protein needs. This is to help the body ensure a speedy recovery.

To determine how much protein you need before or after surgery, take your body weight in kilograms and times it by 1.5 to 2.0. 

So, if you weigh 150LB:

·      Divide your weight in LB by 2.2 to get your weight in kg

o  150/2.2 = 68.2 kg

·      Next, multiply your body weight by 1.5 to 2.0

o  68 times 1.5=102; 68 times 2.0=136 g

·      You should consume 102-136 g per day of protein

If you have any chronic disease like COPD, Chronic Kidney disease, End Stage Renal Disease, HIV, or Cancer, please consult with your doctor or dietitian to determine your protein needs as they may be lower or higher based on your specific condition.

What if I am underweight?

If you are malnourished, it is important that you ensure adequate calories and protein leading up to your surgery. Nutritional status is crucial prior to surgery. A nutritional assessment should be completed prior to any surgery to reduce the risk for postoperative complications, increased length of stay, and risk for infection. A patient can be diagnosed with mild or severe malnutrition by the MD. A Registered Dietitian can also assess the patient for mild to severe malnutrition. 

Why is it important to correct malnutrition before surgery?

It is imperative to correct malnutrition in a patient prior to their surgery. Research proves that malnutrition is a leading reason for poor outcomes postoperative. Studies show that preoperative nutritional deficiency is a strong predictor of 90 days mortality and poor overall survival. Nutrition status can be improved with recommendations from a Registered Dietitian. Common recommendations include high protein supplements such as CF(Protein)®. CF(Protein)® is a plant-based protein product with complete nutrition to help build muscle and strength for a speedy recovery. Other ways to improve nutritional status can include enteral or parenteral nutrition. For obese patients, it is often required to lose excess weight prior to surgery.

If you are preparing for an upcoming surgery, CF(Protein)® can help you meet your increased protein needs and get your body ready for surgery. Visit our website https://drinkclearfast.com/ to learn more.

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Featured Posts For Med Pros Preparing for Surgery Presurgery Nutrition

Importance of Preoperative Nutrition Before Surgery

Nutrition plays a crucial role in surgical outcomes. Implementing nutrition screening and correcting malnutrition before surgery can help reduce readmission rates, postoperative infections, and length of stay. By understanding the components of preoperative nutrition medical professionals can help ensure patients receive the best standard of care.

What is preoperative nutrition?

Preoperative nutrition covers a wide variety of interventions—including nutrition screens, correcting nutrition status before surgery, patient education, and carbohydrate loading up to two hours before surgery. There is a lot involved in preoperative nutrition, and understanding each component can significantly enhance recovery, which is why it is a major component of ERAS®. 

Why does preoperative nutrition matter?

There is a strong association between poor nutrition status and surgical outcomes. Several studies report that preoperative nutrition to correct poor nutrition status improves outcomes postoperatively. To understand the importance of preoperative nutrition and correcting nutrition status before surgery, consider surgery analogous to a marathon. Before a marathon, you train for an extended period to ensure you will finish the race with the fastest time possible. If you have any injuries or illness, you would likely postpone running the marathon until you were healthy because, if not, you will not run as fast and perhaps wouldn’t even be able to finish the race. In the grand scheme of things, surgery is far more critical than running a marathon, so ensuring patients put in the same “training” to enter surgery at their strongest leads to smoother, faster recoveries.

What is the risk of preoperative malnutrition?

Preoperative malnutrition increases the risk for mortality and morbidity, and also increases costs. Malnutrition and cachexia are caused by proinflammatory cytokine response, inadequate dietary intake, and catabolic effects (Ward et al.). Preoperative malnutrition leads to increased susceptibility to infection, impaired wound healing, pressure ulcers, and increased length of stay (Abdelhamid et al.). Therefore, patients who are severely malnourished should correct malnutrition before surgery. In some cases, surgery is postponed until malnutrition is resolved.

Malnutrition and Surgery

Ideally, a nutrition assessment before any surgery can diagnose malnutrition. A Doctor or Registered Dietitian can evaluate the patient for mild to severe malnutrition. The Academy Adult Malnutrition Criteria (ASPEN) has specific criteria to identify malnutrition.

       Research proves that malnutrition is a leading cause of poor postoperative outcomes and it is a strong predictor of 90 days mortality and poor overall survival. Ward et al. suggest that preoperative anorexia and malnutrition increase postoperative complications in Whipple procedures. Furthermore, malnutrition in patients with pancreatic cancer can lead to cancer-related cachexia, defined as greater than 10% weight loss over six months.

CF Nutrition’s Role in helping prevent malnutrition

Nutrition status can improve with recommendations from a Registered Dietitian. Typical recommendations include high-protein supplements in the weeks leading up to surgery, such as CF(Protein)® CF(Protein)® is a plant-based protein drink patients can consume in the days and weeks leading up to surgery to optimize nutrition. It contains high-quality protein, omega-3 fatty acids, and anti-inflammatory ingredients that will enhance the immune system and optimize overall health. It is a complete nutrition product to help build muscle and strength for a speedy recovery.

Other ways to improve nutritional status can include enteral or parenteral nutrition if protein beverages are not enough to restore nutrition status. For obese patients, it is often required to lose excess weight before surgery. The macronutrient excess in those with obesity can be associated with chronic inflammation, sarcopenia, and micronutrient deficiency.

What about preoperative carb-loading?

Surgery induces a catabolic effect on the body. Reducing the fasting period can help reduce this catabolic effect and enhance recovery. Preoperative carbohydrate loading is also an essential component of preoperative nutrition. Prolonged fasting before surgery may cause detrimental effects. Prolonged fasting worsens the catabolic state, and increases metabolic stress, hyperglycemia, and insulin resistance. Furthermore, when the body fasts for a prolonged time, glycogen stores are depleted, leading to protein and muscle breakdown. Postoperative insulin resistance (PIR), a result of the stress response from surgery and further exaggerated with prolonged fasting, is related to delayed wound healing, increased morbidity/mortality, and LOS. Decreased PIR sets patients up for a smoother recovery.

Preoperative carbohydrate loading maximizes glycogen stores in the body as an energy source to minimize body tissue degeneration and reduce PIR. When you change the metabolic state by shortening preoperative fasting, PIR decreases, protein loss drops, and muscle function will improve. Additionally, preoperative carbohydrate loading increases patients’ comfort and reduces hunger, thirst, and anxiety leading up to surgery. Ultimately decreasing stress entering surgery. Our anesthesiologist-developed product, CF(Preop)®, may be consumed before surgery to enhance recovery and shift the body from a fasting to a fed state.

How does preoperative nutrition benefit the medical professional?

Screening patients’ nutritional status, correcting malnutrition and providing preoperative nutrition benefits patients and medical professionals alike. The patient will benefit from a smoother recovery—while the medical professional will benefit from cost savings, reduced length of stay and postoperative complications, increased patient satisfaction, and lower readmission rates.

  In summary, preoperative nutrition is a critical component of surgery. Nutrition screenings, correcting malnutrition, and preoperative carbohydrate loading are necessary interventions before performing surgery. CF Nutrition is here to help you better understand preoperative nutrition and how to incorporate it into your practice. Our products promote a smooth recovery and improved surgical outcomes. 

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For Med Pros Preparing for Surgery

Happier Patients & Better Surgery Recovery: 3 Reasons ERAS® is Being Implemented Around the World

Enhanced Recovery After Surgery, or ERAS® as it’s known in the medical field (pronounced ee-raz), is a program that follows 17 key elements which work together to make for safer surgeries and better surgery recovery for patients. (Psst..if you didn’t catch our breakdown on what ERAS is all about, you can find that here.) The goal of ERAS is to benefit both patients and hospitals by taking a multi-pronged approach to caring for patients throughout their entire surgery journey. With an array of research pointing to endless benefits, it’s no surprise this effective surgery protocol program is becoming increasingly popular. Read on for 3 reasons hospitals around the world are kicking outdated surgery prep to the curb and making the surgery-smart shift to effective ERAS programs instead. 


  1. The research is in. 

As decades go by, we learn more and more about the human body, and medical practices advance as a result. One of the places this is most apparent is in the field of surgery—a slew of modern medical research points to a finding that flips antiquated surgery prep on its head: by making a plan to care for our bodies before surgery (rather than simply fasting from midnight, setting up a ride home, and calling it a day), we can increase our chance of safer surgeries and better surgery recovery. Research shows that following the 17 elements of an ERAS program ultimately “reduces the stress of the operation” and leads to: 

  • Reduced length-of-stay of up to 50% 
  • Reduced rates of surgical complications
  • Higher patient satisfaction scores (HCAHPS) 
  • Lower rates of re-admittance
  • Lower costs

  1. It’s good for the hospital—and great for the patient. 

Better surgery recovery benefits everyone: Hospitals reduce their costs by decreasing re-admittance rates and shortening the length of stay after surgery—while patients see benefits like a reduced risk of post-op infection (more on how surgical infections are tied to presurgery nutrition here) and a significantly reduced risk of post-operative nausea and vomiting (PONV). 


According to Ms McAuliffe, a senior orthopaedic surgical practitioner at East Surrey Hospital, ERAS Programs “focus on every stage of the patient journey, from their initial assessment through to follow-up care. It’s a complete package and leads you to think about the patient as an individual so you can give them tailored care, which is what nursing should be all about.” Ultimately, the fact that ERAS offers a comprehensive approach to surgical care serves up benefits across the board—but particularly for empowered patients who see far better surgery recovery as a result of following ERAS protocols.


  1. There are resources to support patient prep. 

One of the key elements of an ERAS program is using an ERAS-compliant presurgery drink in place of the outdated fasting-from-midnight instructions. (It makes perfect sense when you think about it: rather than entering surgery dehydrated and on an empty stomach, you have a presurgery nutrition plan designed specifically with the human body, anesthesia, surgical risks, and the healing process in mind.) But, sports drinks and chalky nutrition shakes don’t come close to making the cut—an ERAS-compliant drink has to meet a number of standards in order to be both safe to drink before surgery and effective enough to lead to proven enhanced recovery. Because ClearFast Preop was developed by an anesthesiologist specifically to meet ERAS requirements, getting patients ERAS-compliant presurgery nutrition is now a reality for hospitals across the U.S, who use ClearFast as part of their ERAS programs every day. 


———


If you’re ready to wake up from anesthesia feeling great, you can ask your hospital if they have an ERAS program and order your ClearFast Preop Drink here. And, as always, don’t hesitate to 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!


Psst…Want to know even more about the benefits of ERAS? Check out clips from Dr. Olle Ljungqvist’s ERAS TED Talk here

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For Med Pros Preparing for Surgery

What is Enhanced Recovery After Surgery (ERAS)…and Why Should I Pay Attention To It?

If you’re getting ready to go under the knife, you may have heard the term Enhanced Recovery After Surgery—but you’re likely wondering What is enhanced recovery after surgery and why in the world should I pay attention to it? Not to worry, friends—today, we’re breaking down everything you need to know about this effective medical practice and how following it will affect your surgery experience for the better! 

 

What is Enhanced Recovery After Surgery (ERAS)?

Enhanced Recovery After Surgery (or ERAS® as it’s know in the medical field) is all about facilitating a faster, easier recovery after surgery by taking proactive steps to reduce the amount of stress the body undergoes during surgery. 

 

Essentially, ERAS programs focus on implementing different practices to ensure your surgery recovery is the best it can be. ERAS programs are comprised of 17 key elements for your doctors to follow—like pre-admission counseling for patients, the use of short-acting anaesthetic agents, and fluid-fasting with a presugery drink in place of the traditional “no food or drink after midnight” fast. When you and your doctor follow the elements of an ERAS program, together they work to ensure better surgical outcomes and—just like the name states—an enhanced recovery after surgery

 

In other words, the simplest answer to the question: What is enhanced recovery after surgery? is that ERAS programs are all about taking proactive steps to make sure a patient’s surgery experience and recovery are as healthy, safe, and easy as they can be.

 

Why did ERAS programs come about?

ERAS Programs originated in the UK but are are now increasingly popular in hospitals across the United States. As they realize this evidenced-based program leads to safer surgeries and shorter hospital stays, medical professionals around the world are now implementing ERAS programs in their practices.

 

What impact do ERAS programs have and who do they benefit?

There’s a body of evidence pointing to the fact that ERAS programs lead to improved outcomes for hospitals and patients. In fact, according to a PubMed analysis of randomized trials, “Three of four included studies showed significantly shorter primary lengths of stay for patients enrolled in enhanced recovery programs.” 

 

ERAS programs are beneficial to both the patient and the hospital: a healthier patient recovers faster, leaves the hospital in a timely manner, and is overall more satisfied with their surgery experience—this leads to money saved for both the hospital and the patient, as well as higher patient satisfaction, which leads to higher doctor pay.

 

How can I follow ERAS protocols before my surgery—and why should I?

Even if your procedure is relatively minor, the act of undergoing anesthesia is super stressful on the human body. Because of this, the idea behind ERAS is to prep our bodies for that stressful experience in a more purposeful way. Old-school thought has patients not eat or drink anything after midnight (which means undergoing surgery in a weakened state—more on why you shouldn’t fast before surgery here!) and neglects to give us any useful information about how to strengthen your body and mind before you undergo anesthesia. ERAS programs, on the other hand, empower patients with the information they need to get healthy before surgery and enhance their recovery as a result. This includes protocols like:

 

  • Exercising and losing weight if needed
  • Quitting smoking and avoiding alcohol
  • Making healthy dietary choices
  • Replacing the “nothing from midnight” rule with a specific fluid fast 

 

How does ClearFast fit into ERAS programs?

One of the most important of the 17 key ERAS program elements is pre-surgery carbohydrate loading using a compliant ERAS® drink. Replacing the “nothing after midnight” rule with the ERAS-backed suggestion of fluid fasting with a complex-carb beverage can: 

 

  • Make for a less stressful surgery experience: 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.

 

  • Greatly reduce your risk of post-op nausea and vomiting: Being administered heavy anesthesia drugs on an empty stomach is responsible for the sick feeling one in three patients experience upon waking from surgery. (More on reducing post-op nausea and vomiting here!)

 

  • Make for Easier IV Sticks: Dehydration leads to reduced blood flow, which can often mean multiple, painful IV sticks. Many ClearFast customers report easier, pain-free and one-time-only needle sticks as a result of working our preop drink into their surgery prep routine.

 

 

Not just any beverage will work when it comes to proper preop carbohydrate loading, though. The key to this ERAS program element is ensuring you’re using a complex carbohydrate-rich beverage that contains primarily maltodextrins—rather than simple sugars like the fructose found in sports drinks. (Sports drinks simply aren’t an option for enhanced recovery.) ClearFast, on the other hand, is the only domestically produced ERAS drink of its kind that is rich in maltodextrins, chock-full of healing ingredients (like zinc & L-citrulline), is clear and colorless, and free of simple sugars and harmful colored dyes. Essentially, it’s the gold-standard for ensuring an enhanced recovery after surgery.

 

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Overall, the stronger your body is going into surgery, the easier your body will recover upon waking up. ERAS programs are all about empowering both patients and medical professional with this knowledge and encouraging them to take proactive steps in order to create a safer, easier, more beneficial surgery experience for both patients and medical professionals. 


Ready to start your surgery experience off right? Order your ClearFast PreOp Drink here—or reach out to the ClearFast team at support@drinkcf.com if you have any questions at all! 

Categories
For Med Pros Presurgery Nutrition

Answering Your Questions about our Pre Surgery Carbohydrate Drink: The Top 5 ClearFast FAQs

At ClearFast, we get to be on the forefront of an exciting shift in the way the medical industry prepares patients for surgery. With physicians and luminary hospitals across the U.S. now replacing old-school fasting-from-midnight with the consumption of a pre surgery carbohydrate drink instead, we hear from patients all of the time who have questions about this seemingly surprising change in protocol. Today, then, we’re answering your top 5 questions about our pre surgery carbohydrate drink.


  1. But I thought I was supposed to fast before surgery?

First and foremost, you should always follow your doctor’s instructions. That being said, this is definitely the most common question we hear—and understandably so—so let’s break down fasting before surgery versus consuming a pre surgery carbohydrate drink:


  • 150, years ago medical professionals realized having food in your stomach before surgery could cause you to aspirate. 
  • Aspiration is the entry of your stomach contents/food into the lower respiratory tract and lungs—which can be very dangerous during surgery. 
  • In response, medical professionals implemented a new, sweeping rule: patients were to have no food or drink after midnight before their surgery (also called “NPO” or “NPO after midnight” in the medical industry).
  • Fast-forward to the year 2000, when extensive new research (over 30 independent studies) concluded that patients who drank clear fluid before surgery actually had emptier stomachs than their fasting counterparts. 
  • Patients who fasted had a build-up of stomach acids as a result of fasting. Therefore, patients who drank clear fluid prior to surgery were ultimately deemed less likely to aspirate than those who fasted.

So, while you should follow your physician’s specific surgery prep instructions—we do know that modern research points to the fact that consuming a pre surgery carbohydrate drink helps decrease a patient’s risk of aspiration—making the question of a pre surgery drink definitely a worthwhile one to address at your pre-op appointment. (Psst…you can learn more about talking to your doctor about ClearFast here.)


  1. When do I need to have my bottles completed by?

Great question! You should drink your last ClearFast bottle two hours prior to your procedure, unless instructed otherwise. You can check out our drinking instructions and bottle-count recommendations on our website. PRO TIP: Chill your ClearFast overnight for a smooth, tasty option! 


  1. Can I use CF as part of my colonoscopy prep?

Absolutely! Our pre surgery carbohydrate drink is used for colonoscopy prep all of the time (more on ClearFast for Colonoscopy prep here)—and it’s actually pretty perfect for this common procedure for two main reasons:


  • Chase your prep drink: As part of your colonoscopy prep procedure, you have to consume that foul-tasting prep liquid. ClearFast, though, acts as a great “chaser” for your prep drink, helping it go down smoother and easier. (Colonoscopy prep customers say this lifehack makes the dreaded prep experience “totally different.”)

  • Fight dehydration and hunger: Drinking the prep liquid (and emptying your bowels) can lead to major dehydration and electrolyte imbalances. Dehydration and hunger are things you want to avoid in general, but especially before undergoing anesthesia. Because it’s chock-full of complex carbs and electrolytes (while still being colorless and safe to consume before surgery), ClearFast greatly reduces dehydration and hunger before your colonoscopy. 

  1. I’m not usually “starving” as a result of fasting before surgery. Are there other benefits of taking ClearFast before surgery?

The benefits of ClearFast don’t stop at the obvious (that it fills you up and hydrates you). Even if fasting after midnight doesn’t necessarily stress you out or leave you hungry in the morning, our pre surgery carbohydrate drink offers up a number of other benefits. Because it contains six essential nutrients (complex carbohydrates, electrolytes, Vitamin A, Selenium, Zinc, L-citrulline), ClearFast can:

  • Greatly reduce your risk of post-op nausea and vomiting: No more heavy meds on an empty stomach! (More on avoiding getting sick after anesthesia here.)
  • Facilitate easier, less painful IV “sticks”: When you’re hydrated, your veins are much easier to find.
  • Give you an edge on recovery: Zinc and L-citrulline work to heal you faster by promoting healthy circulation and nitric oxide production, while Vitamin-A helps support healthy tissue function. Combined, these properties make for a faster, easier recovery process. 
  1. Why can’t I just drink water?

Hey, we love water as much as the next hydration expert. But, while water will (of course) hydrate you, it isn’t capable of acting as a “liquid food” the way the right pre surgery carbohydrate drink does. Because ClearFast is chock-full of complex carbs (rather than simple sugars like you’d find in sports drinks), it nourishes you before surgery. And pre surgery nourishment plays a huge role in ensuring you don’t get sick upon waking from surgery (from being administered heavy anesthesia meds on an empty stomach full of nothing but water). Plus nutrients that you won’t find in water (like zinc, L-citrulline and Vitamin-A) work together to make for a faster recovery and healing process.


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That’s it for today’s roundup of your top FAQs about our pre surgery carbohydrate drink. You can browse more ClearFast FAQs here, or order your ClearFast Presurgery Drink here if you’re ready to change the game when it comes to your surgery experience. And, as always, don’t hesitate to reach out to the ClearFast team at support@drinkcf.com if you have any questions that we didn’t cover today. We’re always here and more than happy to help!

Categories
For Med Pros

Patient Satisfaction is Tied to Increased Doctor Pay, New Study Shows

As medical professionals, higher patient satisfaction and better surgical outcomes are always something you’re aiming for…for obvious reasons. But a recent study finds that there’s one new major reason to place even more emphasis on happier, healthier patients and better outcomes: your paycheck may depend on it. Today, we’ll cover: 

 

 

  • The link between patient satisfaction scores and doctor pay
  • How to increase patient comfort to yield better patient satisfaction scores
  • How doing away with NPO leads to:
  • Increased patient comfort
  • Reduced PONV & shorter hospital stays
  • Better surgical outcomes
  • Reduced instances of readmission

 

 

Now, let’s dig in… 

 

The link between patient satisfaction scores and doctor pay:

According to a recent Forbes article, More Doctor Pay Tied to Patient Satisfaction and Outcomes, organizations that analyze doctor compensation are noticing a clear trend: as insurance companies move away from fee-for-service reimbursement, they’re turning more toward value-based metrics—such as patient satisfaction scores and outcome measures. In fact, Merritt Hawkins, a physician staffing firm, found in its 2018 review that 43% of its clients who offered doctors a production bonus in 2017 based that additional compensation on value-based metrics. That number is up from 39% the year prior and 32% in 2015. 

 

We also know that there’s a clear trend of health insurance companies—named in the Forbes article are: Anthem, UnitedHealth Group, Aetna, Cigna—that are now shifting more than half of their reimbursement to value-based models, compensating physicians based on things like the health outcomes of their patients and the overall quality of care they deliver. So, what does this mean for practicing physicians? In short, it means that patient satisfaction and health outcomes are more important now than ever—as your paycheck, quite literally, depends on it. 

 

How to increase patient comfort and improve outcomes to yield better patient satisfaction scores:

It’s no surprise that one key factor in patient satisfaction is patient comfort—the two are inherently linked. One simple solution for increasing patient comfort—and, therefore, patient satisfaction—is to replace the old-school fasting-from-midnight (NPO) instructions with an option that allows patients to safely hydrate and nourish with an effective preop drink instead.  By allowing patients to consume a clear, complex carbohydrate-rich beverage in place of NPO, you’re able to increase patient satisfaction, reduce PONV (thereby decreasing the length of hospital stay), produce better surgical outcomes, and reduce the chance of readmission—all of which, we now know, are tied to increased physician compensation:

 

 

  • Increased Patient Comfort: In a large controlled study, patients in the pre-op area who consumed the ClearFast preop drink were 5.5-6.5 times more likely to describe themselves as “comfortable” than their cohorts who underwent traditional fasting from midnight/NPO. Increased patient comfort, we know, leads to higher patient satisfaction scores (HCAHPS)…and, ultimately, increased paychecks.

 

 

 

  • Reduced PONV & Shorter Hospital Stays: In addition to creating a more comfortable pre-surgery experience for patients, fluid fasting with the ClearFast presurgery drink reduces a patient’s risk of PONV, ultimately decreasing the length of his or her hospital stay. Again, this ties directly into patient satisfaction scores.

 

 

 

 

  • Reduced Instances of Readmission: Getting your patients out of the door in a timely manner after surgery is a great startbut that doesn’t mean much if they soon come back due to a terrible infection. Readmission due to infection drastically affects patient satisfaction scores (HCAHPS), as well as how much your hospital gets paid. Because ClearFast is proven to reduce a patient’s risk of surgical site infection (you can read more about the role ClearFast plays in reducing a patient’s risk of infection here), it, in turn, reduces the chances for costly patient readmission—ultimately keeping patients healthy and happy and positively impacting your hospital’s bottom line (and your paycheck). 

 

 

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Overall, ClearFast is such an easy, simple, safe and effective solution for drastically increasing your patient satisfaction scores and, therefore, increasing compensation. If you’re ready to have ClearFast on-hand at your medical practice or hospital, you can order ClearFast here. Or, feel free to reach out to the ClearFast team at support@drinkcf.com if you have any questions at all. We’re always happy to help!

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