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Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial

(1) Background: Vascular surgery operations are hampered by high failure rates and frequent occurrence of peri-operative cardiovascular complications. In pre-clinical studies, pre-operative restriction of proteins and/or calories (PCR) has been shown to limit ischemia-reperfusion damage, slow intima...

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Autores principales: Kip, Peter, Sluiter, Thijs J., Moore, Jodene K., Hart, Abby, Ruske, Jack, O’Leary, James, Jung, Jonathan, Tao, Ming, MacArthur, Michael R., Heindel, Patrick, de Jong, Alwin, de Vries, Margreet R., Burak, M. Furkan, Mitchell, Sarah J., Mitchell, James R., Ozaki, C. Keith
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8621550/
https://www.ncbi.nlm.nih.gov/pubmed/34836280
http://dx.doi.org/10.3390/nu13114024
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author Kip, Peter
Sluiter, Thijs J.
Moore, Jodene K.
Hart, Abby
Ruske, Jack
O’Leary, James
Jung, Jonathan
Tao, Ming
MacArthur, Michael R.
Heindel, Patrick
de Jong, Alwin
de Vries, Margreet R.
Burak, M. Furkan
Mitchell, Sarah J.
Mitchell, James R.
Ozaki, C. Keith
author_facet Kip, Peter
Sluiter, Thijs J.
Moore, Jodene K.
Hart, Abby
Ruske, Jack
O’Leary, James
Jung, Jonathan
Tao, Ming
MacArthur, Michael R.
Heindel, Patrick
de Jong, Alwin
de Vries, Margreet R.
Burak, M. Furkan
Mitchell, Sarah J.
Mitchell, James R.
Ozaki, C. Keith
author_sort Kip, Peter
collection PubMed
description (1) Background: Vascular surgery operations are hampered by high failure rates and frequent occurrence of peri-operative cardiovascular complications. In pre-clinical studies, pre-operative restriction of proteins and/or calories (PCR) has been shown to limit ischemia-reperfusion damage, slow intimal hyperplasia, and improve metabolic fitness. However, whether these dietary regimens are feasible and safe in the vascular surgery patient population remains unknown. (2) Methods: We performed a randomized controlled trial in patients scheduled for any elective open vascular procedure. Participants were randomized in a 3:2 ratio to either four days of outpatient pre-operative PCR (30% calorie, 70% protein restriction) or their regular ad-libitum diet. Blood was drawn at baseline, pre-operative, and post-operative day 1 timepoints. A leukocyte subset flow cytometry panel was performed at these timepoints. Subcutaneous/perivascular adipose tissue was sampled and analyzed. Follow-up was one year post-op. (3) Results: 19 patients were enrolled, of whom 11 completed the study. No diet-related reasons for non-completion were reported, and there was no intervention group crossover. The PCR diet induced weight loss and BMI decrease without malnutrition. Insulin sensitivity was improved after four days of PCR (p = 0.05). Between diet groups, there were similar rates of re-intervention, wound infection, and cardiovascular complications. Leukocyte populations were maintained after four days of PCR. (4) Conclusions: Pre-operative PCR is safe and feasible in elective vascular surgery patients.
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spelling pubmed-86215502021-11-27 Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial Kip, Peter Sluiter, Thijs J. Moore, Jodene K. Hart, Abby Ruske, Jack O’Leary, James Jung, Jonathan Tao, Ming MacArthur, Michael R. Heindel, Patrick de Jong, Alwin de Vries, Margreet R. Burak, M. Furkan Mitchell, Sarah J. Mitchell, James R. Ozaki, C. Keith Nutrients Article (1) Background: Vascular surgery operations are hampered by high failure rates and frequent occurrence of peri-operative cardiovascular complications. In pre-clinical studies, pre-operative restriction of proteins and/or calories (PCR) has been shown to limit ischemia-reperfusion damage, slow intimal hyperplasia, and improve metabolic fitness. However, whether these dietary regimens are feasible and safe in the vascular surgery patient population remains unknown. (2) Methods: We performed a randomized controlled trial in patients scheduled for any elective open vascular procedure. Participants were randomized in a 3:2 ratio to either four days of outpatient pre-operative PCR (30% calorie, 70% protein restriction) or their regular ad-libitum diet. Blood was drawn at baseline, pre-operative, and post-operative day 1 timepoints. A leukocyte subset flow cytometry panel was performed at these timepoints. Subcutaneous/perivascular adipose tissue was sampled and analyzed. Follow-up was one year post-op. (3) Results: 19 patients were enrolled, of whom 11 completed the study. No diet-related reasons for non-completion were reported, and there was no intervention group crossover. The PCR diet induced weight loss and BMI decrease without malnutrition. Insulin sensitivity was improved after four days of PCR (p = 0.05). Between diet groups, there were similar rates of re-intervention, wound infection, and cardiovascular complications. Leukocyte populations were maintained after four days of PCR. (4) Conclusions: Pre-operative PCR is safe and feasible in elective vascular surgery patients. MDPI 2021-11-11 /pmc/articles/PMC8621550/ /pubmed/34836280 http://dx.doi.org/10.3390/nu13114024 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kip, Peter
Sluiter, Thijs J.
Moore, Jodene K.
Hart, Abby
Ruske, Jack
O’Leary, James
Jung, Jonathan
Tao, Ming
MacArthur, Michael R.
Heindel, Patrick
de Jong, Alwin
de Vries, Margreet R.
Burak, M. Furkan
Mitchell, Sarah J.
Mitchell, James R.
Ozaki, C. Keith
Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial
title Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial
title_full Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial
title_fullStr Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial
title_full_unstemmed Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial
title_short Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial
title_sort short-term pre-operative protein caloric restriction in elective vascular surgery patients: a randomized clinical trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8621550/
https://www.ncbi.nlm.nih.gov/pubmed/34836280
http://dx.doi.org/10.3390/nu13114024
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