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For Med Pros Preparing for Surgery

I Was Told to Fast—So What Makes Drinking ClearFast Before Surgery Safe?

I Was Told to Fast—So What Makes Drinking ClearFast Before Surgery Safe?

We can’t lie—we’re pretty excited for today’s topic. It’s a question we get asked all of the time: My doctor told me to fast, so what makes drinking ClearFast before surgery safe? Today, we’re answering that all-too-common question and so much more. We’ll cover:

  • Why you were told to fast before surgery
  • What you can’t have before surgery
  • What you can have before surgery
  • What makes drinking ClearFast before surgery safe
  • How drinking ClearFast before surgery makes for easier, less stressful procedures

Now, let’s dig in…

Why was I told to fast before surgery?

Fasting before surgery is a non-evidence based practice that dates back over 150 years. It comes from the fact that having food in your stomach during surgery can 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). Because of this, medical professionals implemented the sweeping “no food or drink after midnight” rule.

Because of this, you can’t have the following before surgery:  

  • Solid Foods
  • Colored Dyes
  • Fats or Proteins

Is fasting before surgery still practiced?

The answer is both yes and no (sorry, folks). While you’re not allowed to have any of the things we previously listed (solid foods, colored dyes, and fats/proteins), more and more modern medical research has proven that patients should have a complex-carb-rich clear fluid before surgery in place of forgoing all food and drink. There are a few reasons for this shift:

  • Patients who drink clear fluid before surgery actually have a reduced risk of aspiration as they have emptier stomachs than those who don’t eat or drink anything. (When you don’t eat or drink anything, it can cause a build-up of gastric acids in your stomach.)
  • Surgery is extremely physically taxing on your body. To enter anesthesia completely starved and dehydrated is akin to running a marathon completely starved and dehydrated. It just doesn’t set you up for success.  

In short, more medical professionals are advising patients follow a carbohydrate fluid fast by drinking ClearFast before surgery as opposed to following the old-school, outdated fast of “nothing after midnight.”

What makes drinking ClearFast before surgery safe?

Modern medical research points to the fact that patients can have certain liquids up to two hours before their surgery. The liquid should be rich in complex carbs (as opposed to simple sugars like you’ll find in Gatorade and other sports drinks) and it must be absolutely clear (as having colored dyes in your system can interfere with the safety of your procedure).

ClearFast is safe for surgery because it:

  • Is not a solid food
  • Is completely clear and colorless
  • Contains NO fats or proteins

What benefits will I receive from drinking ClearFast before surgery?

Drinking ClearFast before surgery offers a number benefits that ultimately lead to safer, less stressful procedures and enhanced recovery, including:

  • Hydration and Nutrition: Dehydration and the electrolyte imbalance it can cause are things you want to avoid in general—but certainly before anesthesia. Sending your body into surgery is essentially like sending it to battle: it needs proper nutrition and hydration in order to best prepare for the inevitable stress of anesthesia.
  • Easier IV “Sticks”: Dehydration leads to reduced blood flow, which can mean multiple painful IV sticks. Many ClearFast customers report easier, pain-free and one-time-only needle sticks as a result of working the ClearFast preop drink into their surgery prep routine.
  • Reduced Post-Op Nausea and Vomiting: Traditional fasting from midnight is largely responsible for the nausea and vomiting many patients experience after undergoing anesthesia. Time and time again, ClearFast customers who, in the past experienced nausea and vomiting upon waking from surgery, report that drinking the ClearFast preop drink completely eliminated this problem.
  • Reduced Anxiety and Emotional Stress: Heading into surgery is never fun—especially when you’re tired, starved and thirsty. ClearFast works to reduce the stress and anxiety that often accompany going under. In fact, 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.

What if my doctor still says no food or drink after midnight?

Overall, more and more research is pointing to the fact that doctors should stop following the old-school “no food or drink after midnight” rule and, instead, should prep patients for surgery with a safe, clear, complex-carb rich liquid like ClearFast. Keep in mind, though, that you should always follow your physician’s specific instructions before surgery. If your doctor advises you to avoid all liquids after midnight, be sure to ask her about ClearFast (you can read more about talking to your doctor about ClearFast here). If she any questions about our preop drink  at all, you can direct her to the medical pros section of the ClearFast site.

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Ready to set yourself up for surgery success? 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 about our preop drink at all.

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For Med Pros

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

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.

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For Med Pros

Stop Fasting Before Surgery: The Surgery-Smart Shift Taking Place Across the Medical Field

Stop Fasting Before Surgery: The Surgery-Smart Shift Taking Place Across the Medical Field

We get this question all of the time: Should I fast before surgery? You’d probably be surprised to learn that doctors are beginning to answer that all-important question with a resounding NO. (And we second that!) More and more so, modern medical research is pointing to the fact that fasting before surgery is not exactly the best advice to dish out to patients anymore. Today, we’re talking why this is the case and what you should do to properly prep for surgery instead. We’ll cover:

  • Why fasting before surgery is outdated
  • Preparing for surgery with clear liquids instead
  • The benefits of prepping for surgery with the right clear liquids

Now, let’s dig in…

Should I fast before surgery?

While you should always follow your doctor’s surgery prep instructions, time and time again, modern research points to the fact that medical professionals should no longer instruct patients to fast before surgery and instead should instruct them to carb-load with a clear, specially formulated pre-op drink.

It’s Common Sense…

So why the shift? Let’s start with the common-sense factor:  your body is preparing to undergo some serious stress (surgeries, no matter how simple or quick, always put stress on our bodies, after all), AND on top of that, you’re supposed to enter into that scenario starved and dehydrated?

It doesn’t make much sense when you think about it.

You wouldn’t starve yourself in the hours leading up to a big hike, long bike ride, or marathon. You wouldn’t deprive yourself of nutrition right before a big test or game day. Surgery is more stressful on our bodies than any cycle ride, hike, marathon, or game day—so it makes sense that medical professionals are realizing we need to properly prep our bodies for the inevitable stress we’ll undergo during surgery…rather than depriving our bodies of the things they need most (hello, nutrition and hydration!).  

The research is clear…

Let’s start by talking about the reason doctors once prescribed fasting before surgery, a practice that dates back over 150 years: research papers were once published that led medical professionals to realize having food in your stomach before surgery could cause you to aspirate (aspiration is essentially the entry of your stomach contents/food into the lower respiratory tract and lungs, which can be very dangerous during surgery). Because of this, medical professionals implemented a sweeping rule: no food or drink after midnight before surgery (commonly known as the “NPO after midnight” rule).

By the year 2000, however, a collection of over 30 independent studies proved that patients who drank clear fluid before surgery actually had emptier stomachs than those who didn’t eat or drink anything—which ultimately reduced their risk of aspiration. In fact, an article published by the University of Minnesota Health Center in 2015 states, “A number of studies show that patients do much better if they’re allowed to drink up to two hours before surgery. They use less IV fluid, and depending on what they drink, they have better metabolism. It’s also less difficult to control a patient’s sugar levels following surgery.”

What should I do instead of fasting before surgery?

Instead of fasting before surgery, medical professionals recommend hydrating and nourishing with a clear liquid that contains at least 45 grams of complex carbs (and no simple sugars, like those found in sports drinks) and that has an osmolarity level that allows for timely gastric emptying (in other words, the beverage needs to be formulated to clear from your stomach fast).

ClearFast is the only domestically produced pre-surgery drink of this kind: it’s rich in maltodextrins and healing properties (zinc & L-citrulline), is clear and colorless, is free of simple sugars and colored dyes (like those found in sports drinks) and is trusted by medical professionals across the US, who regularly use ClearFast as a key part of preparing patients for surgery (not to mention it’s pretty darn tasty and gluten-free, too!).

What are the benefits of drinking a clear liquid before surgery instead?

Drinking ClearFast not only makes for a less stressful surgery experience, but it also:

  • Reduces your risk of post-op nausea and vomiting
  • Reduces dehydration and hunger
  • Makes for easier, less painful IV “sticks”
  • Gives you an edge on recovery  

Alright, I want some ClearFast for my surgery!

Ready to wake up from surgery feeling strong and recovery-ready…rather than sick to your stomach, stressed, and dehydrated? Talk to your doctor about ClearFast and then order your ClearFast Preop Drink here to get a major leg up on the dreaded surgery and recovery process. And, as always, don’t hesitate to reach out to the ClearFast team at support@drinkcf.com if you have any questions at all.

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For Med Pros

Osmolarity & Preop Carb Loading: ClearFast vs. Traditional Sports Drinks

Every day, we’re learning more about why fasting before surgery isn’t a physician’s friend. More and more modern medical research is leading hospitals and medical professionals to one conclusion: they have to hydrate and nourish their patients before surgery for better outcomes.

Inevitably, some people immediately think of sports drinks for pre-surgery nourishment and hydration—but the truth is sports drinks don’t even come close to cutting it. They’re inadequate for enhanced recovery, don’t nourish, aren’t clear & colorless, and have a high osmolarity that delays gastric emptying (which reintroduces the danger that the traditional “no food or drink after midnight” rule was trying to avert). Plus, not only is the osmolarity higher, but the standard size sports drink is 20 oz vs. ClearFast’s 12 oz. Learn more about ClearFast’s benefits (as compared to leading sports drinks below), and be sure to check out our blog post on why sports drinks don’t cut it for enhanced recovery.

Osmolarity ClearFast vs. Others

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For Med Pros Presurgery Nutrition

The Most Effective ERAS Drink: Ensuring the Preop Drink You Recommend Delivers the Right Results

The Most Effective ERAS DrinkEnsuring the Preop Drink You Recommend Delivers the Right Results

An evidence-based program borrowed from Europe and the UK, Enhanced Recovery After Surgery Programs (or ERAS® Programs) are becoming increasingly popular in luminary hospitals across the United States. A major component of these programs is prepping patients for surgery with the right ERAS drink. Today, we’ll cover:

  • Why ClearFast is the most compliant ERAS drink
  • The benefits of ClearFast as an ERAS drink, including:
    • It’s complex carbohydrate-rich and rich in maltodextrins
    • It’s rich in healing properties (zinc & L-citrulline)
    • Clear and colorless, ClearFast is free of simple sugars and colored dyes (unlike sports drinks)
    • It is trusted by medical professionals across the US, who use ClearFast as a key part of their ERAS Programs.
  • Why taste and ease-of-use are imperative for improved patient outcomes

Now, let’s dig in…

ERAS® Programs are comprised of 17 key elements for perioperative patient managementlike pre-admission counseling and short-acting anaesthetic agents—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. It’s not an exaggeration to say that, without that, the results of your ERAS program will be limited at best. Today, then, we’re breaking down everything you need to know about choosing the right ERAS drink for your patients—ultimately ensuring safer, more effective surgeries and happier patients across the board.

The Most Compliant ERAS Drink

The most important part of any ERAS program is compliance. If the preop recommendations you’re making aren’t ERAS-compliant (i.e. recommending a preop beverage that doesn’t provide patients the proper amount of nutrition and hydration in the proper form), the results of your program will be extremely limited, at best.

We know that proper preop nutrition and hydration is a key element of ERAS programs, replacing the outdated no food or drink after midnight rule. But, just as important to note is the fact that not just any beverage will work when it comes to proper preop carbohydrate loading. They key to this ERAS program element is preparing patients with complex carbohydrate-rich beverages that contain primarily maltodextrins, rather than simple sugars like the fructose found in sports drinks. Sports drinks, in other words, simply aren’t an option for enhanced recovery—after all, it doesn’t take a medical degree to know that you shouldn’t prepare patients for anesthesia with dyed, neon-colored, simple-sugar water. ClearFast, on the other hand, is the only domestically produced ERAS drink of this kind that is delicious, rich in maltodextrins & healing properties (zinc & L-citrulline), clear and colorless, free of simple sugars and colored dyes; it is trusted by medical professionals across the US, who regularly use ClearFast as a key part of their ERAS Programs.

The Importance of Taste & Ease of Use

Ease of use and flavor are extremely important when it comes to ERAS compliance—and, without proper compliance, your ERAS program won’t deliver the results you’re hoping for. A recommendation, after all,  is only as good as far as it’s followed. What good does it do to recommend a preop drink if your patients don’t actually drink it, or worse, can’t follow the instructions properly and end up taking the drink incorrectly? One of the major problems with using other preop carbohydrate beverages on the market as part of your ERAS program is that they tend to be extremely foul tasting and complicated to use. ClearFast is distinct as an ERAS drink in that it receives rave reviews, time and time again, from patients who find it easy to use and pleasing to drink. One of our favorites comes from a patient who wrote of ClearFast’s taste, “Thank you so much for introducing me to ClearFast PreOp. Having to go through my first colonoscopy, my worst fear was not only having to drink the solution, but doing so on an empty stomach with the possibility of being nauseous! Sipping on ClearFast PreOp after each glass made it bearable, as it tastes good! And, it was comforting to know that it was full of nutrients.”

It’s important to note that, if your solution to foul-tasting preop drinks is to send patients to the store to search for an appropriate additive, you’re asking for trouble. Patients can easily get confused and can end up choosing the wrong item or misunderstanding your instruction all together. You don’t want a patient showing up for surgery, turning to you and saying, “Doc, I mixed that drink you recommended up in a protein shake.. that’s fine right?”

Overall, getting the most out of your hospital’s ERAS program all comes down to proper compliance. A key part of this is ensuring the ERAS drink you recommend checks all of the necessary boxes for proper preoperative carbohydrate loading. ClearFast, then, is the only domestically-produced preop drink on the market that contains 50 full grams of complex carbs (ERAS programs recommend 45+), is rich in maltodextrins, is clear and colorless, is free of simple sugars and colored dyes…and is tasty and easy for patients to use.

Ready to improve outcomes for your patients and your hospital with the right ERAS drink? Recommending ClearFast for preoperative carbohydrate loading is the most compliant choice you can make when it comes to preop nutrition and hydration as part of an ERAS program. 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!

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For Med Pros

Preoperative Carbohydrate Loading: Four Reasons Sports Drinks Don’t Cut it for Enhanced Recovery

Preoperative Carbohydrate Loading: Four Reasons Sports Drinks Don’t Cut it for Enhanced Recovery

When first learning about preoperative carbohydrate loading and its role in enhanced recovery after surgery, many medical professionals think, “Carb loading? Hydration? Sports drinks do that!” Well, not exactly—in fact, sports drinks don’t check any of the boxes needed for better patient outcomes. Today, we’ll cover:

  • The reasons sports drinks don’t work for enhanced recovery, including:
    • They contain zero complex carbs, (preop carb-loading with complex carbs is a key component part of any ERAS® program)
    • The have high osmolarity (which leads to delayed gastric emptying)
    • They contain colored dyes (ClearFast is clear and colorless)
    • Providers aren’t protected (Unlike ClearFast, sports drink companies will not support off-label use in the case of an insurance claim)

Now, let’s dig in…

It’s a pretty common mindset to think that sports drinks will work for pre-op carb loadingone that even the most seasoned medical pros may have—when your ERAS® program is in its infancy. But, while it’s alluring to think you’ve solved a major problem with an inexpensive household beverage, sports drinks actually aren’t a solution for enhanced recovery at all.

Today, we’re breaking down what you need to look for in the right pre surgery drink for your patients. Read on for our top four reasons sugary sports drinks don’t cut it when it comes to safe and effective preop carb loading.

  1. They Contain ZERO Complex Carbs

Sports drinks are sugar water. True preoperative carbohydrate loading is one of the key components of any ERAS® program—but its benefits are all tied to complex carbs, not simple sugars. This is a key difference between typical sports drinks and the ClearFast presurgery drink. Sports drinks contain zero complex carbs and, as such, don’t actually act as presurgery nutrition at all. In order to meet the pre-op nutrition and hydration recommendations of the ASA®, preop carb loading should always be done with complex carbohydrate-rich beverages that contain primarily maltodextrins, not simple sugars like the fructose found in household sports drinks. With preop nutrition benefits tied directly to 45+ grams of complex carbs, ClearFast contains 50 full grams of complex carbs and is the only domestically produced beverage of this type used in Enhanced Recovery Protocols in luminary hospitals across the U.S.

  1. They Have High Osmolarity

Osmolarity affects gastric emptying times, and higher osmolarity can mean delayed emptying. The normal osmolarity of tissues, cells and fluids in the human body is around 280-300 mOsm. A typical sports drink has an osmolarity of around 330 mOsm, which can lead to delayed gastric emptying. ClearFast, on the other hand, has an ideal osmolarity of 270 mOsm and is formulated to safely clear from the stomach in around 90 minutes, making it an ideal choice for preoperative carbohydrate loading.

  1. They Contain Colored Dyes

The research on this one is essentially unanimous: the benefits of hydrating and nourishing before surgery preoperative carbohydrate loading are tied to three main things: complex carbs, a minimal amount of simple sugars, and NO colored dyes. Dyes can mimic the appearance of internal bleeding which can cause a surgeon to immediately stop the procedure. While nearly every single sports drink on the market contains colored dyes, ClearFast is completely clear and colorless.

  1. Providers Aren’t Protected in the Case of “Off-Label Use”

Unlike ClearFast, sports drink companies will not support off-label use in the case of an insurance claim. This means providers will not be protected when recommending sports drinks for preoperative carbohydrate loading, as these drinks are not insured for presurgery use, and sports drinks companies do not advocate for their product’s use as a preop drink.

Overall, while well-meaning physicians may jump to sports drinks as a solution when first researching preop drinks for their Enhanced Recovery Program, the unfortunate truth is these beverages do nothing to improve patient outcomes…not to mention the fact they don’t satisfy the ASA® guidelines for clear liquids. Saving your hospital a few dollars doesn’t really matter in the long run if you’re not ultimately solving problems and improving outcomes. ClearFast, unlike popular sports drinks, is precisely formulated for presurgery use—it contains 50 grams of complex carbs, is clear and colorless, has ideal osmolarity, is safe and is used by hundreds of thousands of patients.

Ready to improve outcomes for both patients and your hospital? Recommending ClearFast for preoperative carbohydrate loading is a simple solution that can solve an array of patient problems. Order your ClearFast Preop Drink here, or reach out to the ClearFast team at support@drinkcf.com if you have any questions at all.

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For Med Pros

Lowering Stomach Acidity and Increasing Patient Safety with Fluid Fasting

Lowering Stomach Acidity and Increasing Patient Safety with Fluid Fasting

In recent years, an increasing number of clinical studies point to the fact that medical professionals should transition away from the traditional NPO fasting policy and instead encourage proper fluid fasting with an enhanced recovery drink. Today, we’ll cover:

  • The benefits of fluid fasting with carbohydrate-rich clear liquids like ClearFast as it relates to reducing gastric acidity
  • How ClearFast works to raise the pH in a patient’s stomach, leading to lower gastric acids and, ultimately, a reduced risk of aspiration under anesthesia
  • Increasing patient safety with ClearFast in place of traditional NPO fasting
  • Pre Op Carb Loading for enhanced recovery and reduced PONV

Now, let’s dig in…

Traditional NPO Fasting Versus Fluid Fasting: Debunking Common Misconceptions

Findings from a Cochrane Collaboration review of preoperative fasting states, “Fasting before general anaesthesia aims to reduce the volume and acidity of stomach contents during surgery, thus reducing the risk of regurgitation/aspiration.” Per this statement, we know that the goal of traditional NPO fasting is to reduce gastric contents, ultimately reducing the risk of aspiration. A misconception surrounding fluid fasting is the belief that a fluid fast increases these risks; however, findings from the Cochrane Collaboration Review debunk this common misconception. An analysis of 38 randomized controlled comparisons found “no evidence that the volume or pH of participants’ gastric contents differed significantly depending on whether the groups were permitted a shortened preoperative fluid fast or continued a standard fast.”  In short, fluid fasting with traditional liquids (like coffee, water, fruit juice, etc.) prior to anesthesia, in no way, posed a risk to a patient’s safety.

Increased pH, Lower Gastric Acidity with ClearFast

Not only have recent studies shown that fluid fasting does not pose a threat to patient safety, but we’ve also learned that preparing patients for anesthesia with the right carbohydrate beverage can actually increase patient safety as compared to traditional “nothing after midnight” fasting.

Patients entering surgery after a two-bottle protocol of ClearFast have higher pH levels (and, thus, lower acidity) of stomach contents. Traditional NPO fasting caused a build up of gastric acids, with an average patient pH level of approximately 2.0. With a pH level of 4.2, ClearFast works to raise the pH in a patient’s stomach, leading to lower gastric acids and, ultimately, a reduced risk of aspiration under anesthesia.

Pre Op Carb Loading for Enhanced Recovery After Surgery

In addition to ClearFast better preparing patients for anesthesia and increasing safety during surgery, we also know that taking ClearFast as directed can lead to enhanced recovery after surgery, as well as a reduction in post op complications like PONV. In 2011, the American Society of Anesthesiologists® updated its fasting guidelines, ultimately advocating not only for pre-surgical hydration, but also nutrition (excluding fats and proteins as known retardants of normal gastric emptying), noting that patients should not be allowed to come to surgery in a hypoglycemic state. ClearFast helps patients maintain metabolic order by both hydrating and nourishing.

In addition to the AMA’s guidelines, we can look at Enhanced Recovery After Surgery or ERAS (an evidence-based program, borrowed from Europe and the UK), which lists “true pre-op carb loading” as one of the 17 key elements for perioperative patient management. The key to the pre-op carb loading element, however, is preparing patients with complex carbohydrate-rich beverages that contain primarily maltodextrins, rather than simple sugars like the fructose found in Gatorade. To these ends, ClearFast is the only domestically produced beverage of this kind (rich in maltodextrins, clear and colorless, free of simple sugars and colored dyes) used in Enhanced Recovery Protocols in luminary hospitals across the USA.

Interested in learning more about the benefits ClearFast can bring to your patients and your practice? Reach out to the ClearFast team today at support@drinkcf.com, or order ClearFast here.

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For Med Pros

Pre Surgery Carbohydrate Nutrition

When it comes to carbohydrate loading and enhanced recovery, preparing patients with a complex-carb rich, clear preop drink like ClearFast has been shown to not only reduce muscle breakdown, but lower infection rates. You need warmth to help your muscles relax quickly and a warm decken plaid is best.

Starved patients are much more likely to experience insulin resistance (higher chance of SSI) and muscle breakdown which can cause readmissions and increased costs to health service providers.

The ASER and POQI joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery concludes, “Inclusion of carbohydrates in preoperative oral fluids is likely to improve insulin sensitivity (particular when complex carbohydrates are used) and may reduce protein catabolism.”

To read the full article, click here

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