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Category: Preparing for Surgery

Categories
Preparing for Surgery

What are the Key Considerations for Consuming a Preoperative Carbohydrate Drink Before Surgery?

What are the Key Considerations for Consuming a Preoperative Carbohydrate Drink Before Surgery?

The recommendation for consuming a clear, carbohydrate-rich beverage up to two hours before surgery is based on several key considerations:

  1. Gastric Emptying: Clear liquids are quickly digested and emptied from the stomach. This is crucial because if the stomach contains solid or fatty foods during anesthesia, there is a risk of aspiration (breathing in stomach contents into the lungs), which can lead to serious complications. 

CF(Preop)® has no protein and no fat and contains 50 grams of complex carbohydrates. This allows it to be completely emptied from the stomach in 90 minutes. 

  1. Hydration and Nutrition: A carbohydrate-rich drink helps maintain blood sugar levels and provides some energy, which can be beneficial for the patient’s overall well-being and recovery. It also helps prevent dehydration, which can occur during fasting and can complicate surgery and recovery.

CF(Preop)® contains electrolytes, vitamins and minerals to help promote hydration and nutrition before surgery. 

  1. Patient Comfort: Allowing patients to drink clear liquids up to two hours before surgery can reduce feelings of hunger and thirst, leading to increased patient comfort and satisfaction.

CF(Preop)® contains 200 calories and helps patients feel less hunger and anxiety before surgery. 

  1. Reduced Risk of Complications: Research has shown that prolonged fasting can lead to worse patient outcomes, including increased postoperative nausea and vomiting, insulin resistance, and longer hospital stays. By providing a clear carbohydrate drink, these risks can be mitigated.
  1. Safety: Clear liquids are less likely to cause an emulsion (a mixture of two liquids that normally don’t mix) in the stomach, which could delay gastric emptying. The absence of colorants and dyes also ensures that the liquid is easily identifiable and reduces the risk of any confusion or misidentification during the surgical process.

CF(Preop)® is clear and colorless and contains no artificial dyes. 

  1. Clinical Evidence: The “2-4-6-8 rule” and similar guidelines from international anesthesia societies are based on clinical evidence and expert consensus. These guidelines have been developed to balance the need for patient safety with the benefits of preoperative hydration and nutrition.

In summary, a clear carbohydrate-rich beverage like CF(Preop)®  is recommended because it provides essential nutrients and hydration while minimizing the risk of aspiration and other complications associated with surgery and anesthesia. It is an important part of preoperative care that can improve patient outcomes and satisfaction.

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Preparing for Surgery

Our Top Tips to Prepare For Surgery

Surgery can be an extremely stressful and daunting experience. However, with the right approach, you can optimize your surgical journey and recovery. Today, we will share our top tips to help you prepare for surgery and optimize recovery.

Tip #1 Preoperative preparation

The best way to ensure you are properly prepared for surgery is to follow all instructions given by your healthcare team diligently. This typically includes fasting requirements, medication adjustments, and lifestyle modifications. CF(Preop) is essential to help reduce surgical complications. Make sure to order 2 bottles of CF(Preop) in time for surgery. We recommend drinking one bottle the night before surgery and one bottle up to two hours before surgery. For full drinking instructions, click here to learn more. 

Tip #2 Communicate with your surgical team

It is crucial to maintain open communication with your surgical team. Make sure to address any concerns or queries you may have to alleviate any anxiety leading up to your procedure. Do not hesitate to ask questions about what to expect especially when it comes to recovery.

Tip #3 Focus on nutrition

In the weeks and even months leading up to surgery, embrace a well balance diet rich in nutrients to promote optimal healing post-surgery. This includes fruits, vegetables, whole grains, healthy fats, and lean protein. We also recommend sipping on CF(Rehydrate) Immunity+ in the weeks leading up to surgery to help support your immune system. Consider speaking with a Registered Dietitian for specific dietary guidelines.

Tip #4 Get active if approved my your physician 

We recommend engaging in light physical activity as approved by your provider to enhance your physical fitness and prepare your body for your procedure. It is also crucial to mentally prepare for surgery. Try some relaxation techniques such as deep breathing or meditation. These can help calm your mind and reduce stress prior to surgery. 

Tip #5 Plan a postoperative care plan

Be sure to understand your postoperative care plan outlined by your surgical team. Follow all medication schedules, wound care instructions, and follow up appointments. If you will need anyone to drive you to your appointments make sure to organize this prior to your surgery date. Surround yourself with a strong support system during your recovery period.

Tip #6 Have patience and rest

It may be hard to sit still and rest after surgery, but it is imperative to allow yourself ample time to rest up and recuperate post-surgery. Avoid strenuous activities and prioritize sleep to aid in the healing process.

By incorporating these tips into your surgical journey, you can proactively prepare for surgery, optimize recovery, and pave the way for a smoother healing process.

Categories
Nutrition Preparing for Surgery

How to Optimize Your Post Surgery Recovery With Nutrition

We know that recovering from surgery can be stressful and let’s face it, it’s TOUGH? Just like many things in life, focusing on nutrition after surgery can help you bounce back faster than ever! Today, we break down how you can optimize your recovery through nutrition. 

Tip #1 Eat Enough Calories- especially from Protein

Surgery puts your body under a TON of stress. Your main priority after surgery should be adequate nutrition and calories- NOT weight loss. Some people fear that due to inactivity, recovery may cause weight gain. This is a valid fear, but decreasing calories after surgery is not recommended. In actuality, your caloric needs are actually higher because your body needs extra fuel during the healing process. Protein becomes especially important to help your body heal and for tissue repair and growth. If you undereat during the healing process, your recovery time may be prolonged. If you are unsure of how many calories and how much protein you need after surgery, it is best to speak to your healthcare professional. 

Tip #2 Hydrate!

Equally as important as getting adequate calories from food comes HYDRATION! Typically, it is recommended to drink at least 8 cups of water per day. During recovery, adequate hydration is crucial! If you are not already in the habit of keeping your water intake up, then now is the time to start. In order for your body to heal, maintaining adequate hydration is key. In addition, certain medications may require you to consume more fluid than normal, so check with your doctor. 

CF Nutrition offers two amazing hydration products that will come in handy during recovery. CF(Rehydrate)® Immunity+ and CF(Rehydrate)®  are excellent choices for optimal hydration after surgery. Each drink has key vitamins, minerals, and electrolytes to effectively replenish and hydrate. Order these products now to accelerate post surgery recovery.

Tip #3 Eat Balanced Meals

As we pointed out above, now is not the time to diet, but it is the time to focus on nutrient dense meals. Post surgery, eating well balanced meals and a variety of foods helps your body get the nutrients it needs for tissue repair. Try to get all three macronutrients in to help accelerate your recovery. This means, you want to include protein, carbohydrates, and healthy fats. It is also important to include fruits and veggies to get in your micronutrients.

Here are some examples of great post surgery meals:

  • Salmon with Potatoes and Brussel Sprouts
  • Chicken Breast with Brown Rice, Broccoli and Avocado
  • Black Beans and Brown Rice with Bell Peppers and Onions
  • Avocado Toast With a Hard Boiled Egg and Fruit
  • Mahi Mahi on a Whole Wheat Tortilla with Avocado Slices
  • Greek Yogurt with Sliced Almonds and Blueberries 

Recovering from surgery is no joke- but with the proper nutrition, you CAN accelerate your recovery. Take control of your nutrition and follow these tips to feel your best after surgery. Visit our website for more post surgery tips and tricks.

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For Med Pros Preparing for Surgery

4 Ways to Reduce Stress and Anxiety Before Surgery

Surgery, though necessary, can cause stress and anxiety in several people. We understand how scary going into a medical procedure can be and we are here to help. There are several tools and tips available to take control of your mental state leading into surgery. Since surgery already causes stress to your body, it is crucial to learn what you can do to reduce your stress and anxiety so you can go into surgery in the best possible shape to ensure a quick recovery. Today, we break down ways to manage your stress and anxiety in the days and weeks leading up to your surgery. 

Tip #1 Drink CF(Preop)® Before Surgery

One cause of stress and anxiety prior to surgery is being required to fast from midnight to surgery. On top of the stress of getting surgery, the additional burden of having to abstain from eating or drinking may worsen anxiety in several patients. Luckily, this old surgical doctrine that requires patients to fast from midnight to their surgery time is outdated. In the 1990s, evidence-based research suggested that it was not necessary to be NPO after midnight before surgery. Furthermore, there are detrimental effects caused by this period of prolonged fasting, including anxiety and stress. A systematic review that included 17 randomized control trials with a total of 1,445 patients showed that preoperative carb loading significantly improved patients comfort and reduced anxiety before surgery.

One way to reduce anxiety before surgery is to drink CF(Preop)®. Patients should drink the first bottle the night before their surgery and a second bottle 2 hours before their surgery is scheduled to begin. For additional drinking guidelines, watch this short video: CF(Preop)® Drinking Instructions. 

Tip #2 Educate Yourself About Your Surgery

Feeling anxious about surgery is normal, especially if you are not fully educated on what your surgery entails. In order to feel better about going into surgery, it is crucial to educate yourself. While the internet is a great way to get facts, speaking to your Surgeon or Nurse is an even better way to understand your surgery fully. The more you know about the medical procedure you are having, the better you will feel. Pay close attention to the reason you need surgery. If you focus on how much better you will feel after surgery, you are much more likely to have a positive outlook on your procedure. 

Tip #3 Prepare Your Body For Surgery

Ensuring you are in the best shape possible before surgery can be crucial in overall outcomes. There is a strong association between poor nutritional status and surgical outcomes. Several studies report that preoperative nutrition to correct poor nutritional status improves outcomes postoperatively. This may mean you need to gain or lose weight before your surgery. To understand the importance of perioperative nutrition and correcting nutritional 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 healed and fully recovered because if not, you will not run as fast and perhaps wouldn’t even be able to finish the race. In the big scheme of things, surgery is far more critical than running a marathon, so putting in the same “training” and making sure you are at your strongest before going into surgery will help you recover smoother and quicker. That is why at CF Nutrition, we strive to educate our clients on the importance of perioperative nutrition. 

Appropriate preoperative nutrition can reduce complications and short hospital stays. CF(Protein)® is a plant-based protein drink you can consume in the days and weeks leading up to your surgery to optimize your nutrition. It contains high-quality plant protein, omega three fatty acids, and anti-inflammatory ingredients that will enhance your immune system and optimize your 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. For obese patients, it is often required to lose excess weight before surgery. 

Tip#4 Seek Alternative Therapies For Anxiety

Surgery isn’t the only thing that causes stress in our lives. Hopefully, you know by now a few ways to manage stress. Before surgery, it is imperative to practice these daily.

 If you can’t seem to come up with ways to manage stress, here are a few ways we find help us manage stress:

  • Go for a Walk
  • Practice Yoga
  • Call a Friend
  • Spend Time With your Pet
  • Read a Book
  • Journal
  • Take a Bath

Now that you know how to manage stress and anxiety before surgery, put these tips and tricks into action to accelerate your recovery. Visit our website for more information on surgery.

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For Med Pros Nutrition Preparing for Surgery

Is CF(Preop)® Safe For Patients with Diabetes?

One of the most asked questions when it comes to CF(Preop)® is whether or not patients with diabetes may consume it before surgery. Today, we break down the research surrounding preoperative carbohydrate loading for patients with diabetes. We also discuss CF Nutrition’s protocol for carbohydrate loading in patients with diabetes.

 Why is preoperative carb loading necessary?

Before ERAS® protocols were discovered, the traditional approach to surgery 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. 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 LOS . 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, and shortening preoperative fasting (aka providing a complex carbohydrate 2-3 hours prior to surgery), PIR will be decreased, protein loss will be reduced, and muscle function will improve.

What has CF Nutrition done to research the use of CF(Preop)® for patients with diabetes?

The founder of CF Nutrition, Dr. Lou Marsh, researched CF(Preop)® and blood glucose levels extensively. She found that after ingestion of 50 grams of carbohydrate, the blood glucose levels will spike in any individual. What becomes important is the time the patient drinks CF(Preop)® and the time the blood glucose levels are checked. This will help to see where each specific patient’s blood glucose levels are at two hours after consuming CF(Preop)® and eliminate any excess intervention which leads to hypoglycemia intra-operatively. If blood sugars are checked prior to the two hour mark, excess insulin may be prescribed which leads to hypoglycemia intra-operatively. CF Nutrition provides a questionnaire to help create a standardization of care for checking blood glucose before, during and after surgery. 

What research studies support preoperative carb loading in patients with diabetes?

Administering a carbohydrate drink prior to surgery leaves some surgeons skeptical on the effects it may have on blood glucose levels. Unfortunately, several studies exclude diabetic patients. However, there are some studies that have been done to evaluate the safety of administering dextrose to diabetic patients undergoing surgery. Gustafsson et al conducted a study to evaluate the safety of preoperative carbohydrate loading on patients with diabetes. Twenty-five patients were included with type 2 diabetes (mean HbAlc 6.2± 0.2%) and 10 healthy control subjects. A carbohydrate drink (400mL, 12.5%) was given with the determination of gastric emptying. 

As expected, peak glucose was significantly higher in the diabetic patients compared to the control (p<0.01) and occurred later after intake of the carbohydrate drink (p<0.01). Glucose returned to baseline in 180 minutes in diabetic patients and 120 minutes in the control group (p<0.01). In terms of gastric emptying, at 120 minutes, 10.9 ± 0.7% and 13.3 ± 1.2% of paracetamol remained in the stomach in diabetic and healthy subjects respectively. Gastric half-emptying time occurred at 49.8 ± 2.2 minutes in diabetics and 58.6± 3.7 minute in healthy subjects (p<0.05). These results illustrate that there are no signs of delayed gastric emptying. Therefore, a carbohydrate drink can safely be administered 180 minutes before anesthesia without risk of hyperglycemia or aspiration risk preoperatively according to the results from this study.

​Furthermore, Li Na Ge et al conducted a systematic review to examine the effectiveness and safety of oral carbohydrates in those with diabetes. The review included 5 randomized control trials. Because there are no widely accepted indicators of the effects of preoperative carbohydrate in surgical patients with diabetes, this systematic review intended to offer a basis for the progress of ERAS® pathways for diabetic patients. This systematic review concludes that preoperative oral carbohydrate is effective, safe, and feasible for patients with diabetes. When a diabetic patient is fasted, the lack of glycogen reserve can lead to an insufficient energy supply, strong fluctuation of blood glucose, increased risk of hypoglycemia, nerve and kidney damage, and injury of tissues and organs. Additionally, prolonged fasting increases stress. This increased stress joint with surgical trauma can lead to increased glucocorticoids and glucagon, reduced insulin sensitivity, and reduced utilization of glucose in peripheral tissues. As a result, patients are at risk for postoperative hyperglycemia and increased insulin resistance. Postoperative insulin resistance can increase risk for developing infection and increasing length of stay. By consuming an oral carbohydrate 2-3 hours before surgery, the energy supply is enhanced consequently reducing perioperative hypoglycemia and insulin resistance. 

Providing a carbohydrate drink prior to surgery may help to reduce the stress response of surgery and put the body into a FED state entering surgery. Putting the body into a more normal physiological state entering surgery may be advantageous in overall recovery. 

What are CF Nutrition’s recommendations for CF(Preop)® and patients with diabetes?

With all this being said, here are important things to consider when providing CF(Preop)® to a diabetic patient:

1. Do they have a known risk for delayed gastric emptying? If so, consider adjusting the window for consuming CF(Preop)® per MD recommendations

2. A pt’s blood glucose will spike after the consumption CF(Preop)® however, it should return to baseline

3. Blood glucose should be checked regularly 

CF Nutrition  Recommendations:

Type 1 Diabetic 

With appropriate insulin administration, yields euglycemia. 

• 1st Bottle: Drink the night before surgery once in the fasting window 

• 2nd Bottle: Complete 2 hours before surgery Patients simply “match their short-acting insulin injections” to their blood glucose level and to the carb load that is listed on the drink label.

Type 2 Diabetic 

With preservation of their oral antihyperglycemic agent schedule at bedtime. 

• 1st Bottle: Drink the night before surgery once in the fasting window

• 2nd Bottle: Complete 2 hours before surgery Morning dose of oral agent may be held based on the actual surgical time, e.g., as when surgery is scheduled as one of the first cases of the morning.

Now that you know CF(Preop)® may be used in patients with diabetes, visit our website to purchase today!

Categories
For Med Pros Nutrition Preparing for Surgery

Prepare Your Patient for Surgery With CF Nutrition

At CF Nutrition, our goal is to help prepare your patient for surgery with premium nutrition beverages. Our mission is to use clean ingredients you can feel good about giving to your patients and we do not use any artificial ingredients or dyes. We know that surgery can be a stressful time so our products are designed to help reduce the surgical response of surgery and improve surgical outcomes. We have a full product suite that provides support to your patient before, during, and after their procedure.

Provide CF(Protein)® in the weeks leading up to surgery:

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 an operation. Plant protein is the modern way to give your body the best nutrients with the lowest impact on your digestive system.

Each CF(Protein)® has 13g of protein per bottle. So, depending on what else your patient is eating or drinking, and their specific protein needs, consuming 1 to 2 CF(Protein)® drinks per day can help ensure your patient is optimizing their 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 your patient feel strong and well-nourished for their operation. 

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

Recommend CF(Preop)® the night before and morning of surgery:

CF(Preop)® is a clear, colorless drink specifically formulated by an anesthesiologist for safe consumption in the hours before surgery. Each of its premium ingredients has been intentionally chosen to promote the highest level of presurgery safety, comfort, and nourishment.

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 carbohydrates 2 hours prior to surgery). There is no protein or fat in CF(Preop)® in order for it to safely empty your patient’s stomach before surgery. If your patient has delayed gastric emptying due to an underlying condition, CF(Preop)®  should be consumed 3-4 hours before the procedure. 

Provide CF(Rehydrate)®  or CF(Rehydrate)® Immunity+ after surgery:

After surgery, patients are oftentimes very dehydrated and can only have clear liquids. The intentional formulation behind both CF(Rehydrate)® and CF(Rehydrate)® Immunity+ replenishes lost fluids and essential electrolytes. CF(Rehydrate)® and CF(Rehydrate)® Immunity+ also has an ideal combination of carbohydrates and sodium to help you recover quicker. Recommending either post surgery can help promote recovery and hydration. 

Now that you know CF Nutrition offers a wide variety of products to help improve surgical outcomes, head to our website to purchase or receive samples!

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Medical Professionals Preparing for Surgery

How is L-Citrulline better than L-Arginine?

CF(Preop)® contains L-citrulline to help improve blood flow by increasing nitric oxide levels. Other pre-surgery carbohydrate drinks contain L-arginine. Today, we break down why L-citrulline is more effective than L-arginine further illustrating that CF(Preop)® is the superior carbohydrate drink before surgery.

What is L-citrulline?

L-citrulline is a non-essential amino acid and we can make it in our bodies. L-citrulline is a key component of the urea cycle. 

What role does L-citrulline play in CF(Preop)®?

  CF(Preop)® contains L-citrulline. L-citrulline improves circulation by increasing nitric oxide levels, boosts the immune system by nourishing bowel electrolytes, and is efficiently converted to L-arginine. CF(Preop)®’s competitors do not contain L-citrulline.

Why is L-citrulline better than L-arginine?

When L-arginine is consumed orally, it undergoes significant breakdown by the enzyme arginase in our gastrointestinal pathway. Arginase hydrolyses arginine into ornithine and urea. When this happens, the result is low plasma L-arginine levels and lower bioavailability of L-arginine for nitric oxide synthesis. 

Furthermore, L-citrulline supplements are shown to increase arginine levels more than arginine supplements themselves. Arginine is subject to a number of pre-systematic and systematic elimination processes. Arginine is rapidly metabolized by liver and small intestine but catabolism of L-citrulline in the intestine is limited. L-citrulline is not metabolized by arginases and bacteria. L-citrulline is not extracted from the systemic circulation for clearance by the liver.

What are the benefits of supplementing L-citrulline?

Supplementation of L-citrulline:

  • May help with muscle recovery and blood flow
  • May reduce blood lactate levels
    •  L Citrulline can decrease lactate production and therefore increase time to exhaustion, in turn increasing physical performance 
  • Increases the circulation and tissue Arginine than an equivalent dose of Arginine 
  • May reduce blood pressure
  • Can increase nitric oxide synthesis activation
Categories
For Med Pros Preparing for Surgery

    CF Nutrition Products During Cancer Treatment

CF Nutrition products help nourish, hydrate, and better prepare your patients for surgery. Our products may be beneficial to your patients diagnosed with cancer to help them recover faster after surgery and to stay hydrated during treatments. 

 CF(Preop)® Before a Cancer Procedure

   If your patient is undergoing surgery related to their cancer treatment, CF(Preop)® can help them enhance their recovery after surgery. We recommend advising your patients to consume one CF(Preop)® at 8:00 PM the night before their surgery and one CF(Preop)® on the morning of their surgery (up to two hours before surgery/procedure).

           ERAS® protocols, specifically preoperative carbohydrate loading before surgery, have shown positive results in recent studies on cancer patients. Often, surgical resection is the only cure for certain types of cancer. During surgery, the body’s stress response increases, inhibiting immune function and increasing inflammatory markers (Wang et al.). In turn, recovery is delayed, and the risk for infection and postoperative complications increases. The goal of ERAS® protocols is to maintain organ function and decrease stress response following surgery. By reducing the stress response, the body will return to normal physiology sooner, which is crucial in cancer patients. Therefore, consuming CF(Preop)® before surgery will allow them to recover from their surgery sooner and decrease the risk for postoperative complications. 

CF Nutrition Products During Chemotherapy 

 If your patient is undergoing chemotherapy, consuming CF(Rehydrate)® throughout their chemotherapy duration can help them replenish their body with medical-grade nutrition and hydration needed to prevent dehydration. 

 If they are receiving chemotherapy, replenishing their body afterward is crucial. Dehydration is a common side effect of cancer treatments. Additionally, vomiting and diarrhea are also common side effects of chemotherapy which again lead to dehydration. We recommend advising patients to consume CF(Rehydrate)® or  CF(Rehydrate)® IMMUNITY+ after their session, along with the days following. In doing so, they will replenish their body with the vitamins, minerals, electrolytes, and fluid they need to feel better as soon as possible. Consuming CF(Rehydrate)® or  CF(Rehydrate)® IMMUNITY+ throughout their chemotherapy duration can help your patient to combat chemotherapy’s adverse side effects and prevent dehydration.  

         Unfortunately, if your patient is receiving chemotherapy, CF(Protein)® may not be recommended. It is important to note CF(Protein)® contains turmeric. Turmeric has blood-thinning properties and may interact with certain chemotherapy medications. When it comes to turmeric, the dosage does make a difference. There is 0.3g of turmeric in one bottle of CF(Protein)®.  Curcumin may act as an estrogen hormone. So, it may make hormone-sensitive conditions worse. Although this is not proven, if your patient has any hormone-sensitive need, avoid turmeric or use it with caution and only with MD approval. Hormone-sensitive conditions include breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids.

Now that you know what CF Nutrition products may be right for your patient undergoing a procedure or cancer treatment, head to our website to learn more and receive samples for your patients to try. 

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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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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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