Early intravenous branched-chain amino acid-enriched nutrition supplementation in older patients undergoing gastric surgery: a randomized clinical trial

作者：Yimei Ma, Zhao Xining, Pan Yan, Yuying Yang, Ying Wang, Shengjin Ge · 发表于：Nutrition Journal · 年份：2024 · DOI：10.1186/s12937-024-01041-0 · 被引用次数：9 · 研究领域：Enhanced Recovery After Surgery、Clinical Nutrition and Gastroenterology、Nutrition and Health in Aging

BACKGROUND: The initiation time and formula for supplemental parenteral nutrition after surgery require optimization, especially in older patients undergoing major gastrointestinal surgery. This study aimed to assess the effect of early supplementation with a branched-chain amino acid (BCAA)-enriched formula (BAF) on short-term postoperative outcomes in older patients undergoing gastric surgery. METHODS: This single-center, prospective, double-blinded, randomized clinical trial was conducted from March 10, 2020, to September 15, 2022. Patients aged 65-80 years with gastric cancer scheduled for curative resection were assessed for eligibility and randomly allocated to a high-proportion BCAA (HBCAA) (early supplementation with the BAF) or control (routine nutrition) group. The primary outcome was the standardized length of hospital stay (LOS). RESULTS: A total of 150 patients were randomized. Thirteen patients were excluded due to the resection of other organs, presence of metastasis, or withdrawal of consent. Finally, we included 70 and 67 patients in the HBCAA and control groups, respectively (mean age: 70.5 ± 4.2 years; 96 men [70.1%]). The standardized LOS was significantly shorter in the treatment group than in the control group (median [interquartile range]: 8.0 [7.8, 8.0] vs. 8.5 [8.0, 9.0] days; mean difference, 0.38; 95% confidence interval [CI], 0.02-0.74 days; P < .001). Patients in the HBCAA group showed better gastrointestinal function with faster defecation (4.0 [...