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Query: UMLS:C0038187 (starvation)
 24,951 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Anorexia nervosa and bulimia are appearing with increasing frequency in preadolescents and adolescents. Eating disorders lead to significant physical changes related to starvation and/or purging. These patients should be specifically questioned about taking laxatives, diuretics, or amphetamines to lose weight. Subclinical abnormalities, coupled with the patient's denial, emphasize the need for careful physical examination and laboratory assessment. Preexisting electrolyte, cardiovascular, and thermoregulatory alterations must be recognized so that an appropriate anesthesia plan can follow.
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PMID:Anesthesia considerations for anorexia nervosa and bulimia nervosa. 813 98

Two hundred and thirty healthy children scheduled for receiving elective minor surgery were assigned into 4 different groups. Group I (small infant group) included 27 infants of age from 1 to 3 months (2.0 +/- 0.6 months), Group II (infant group) included 42 infants age from 3 to 12 months (7.4 +/- 2.8 months), Group III (pre-school children group) included 122 patients of age from 1 to 6 years (3.1 +/- 1.4 years). The remained 39 cases of age older than 6-years-old (8.0 +/- 1.5 years) were collected in group IV (old children group). All studied children were starved for at least 4, 6, or 8 hours in infants, pre-school children, and old children group, respectively, pre-operatively. The fasting time and fasting blood glucose levels of the 4 groups were 6.7 +/- 1.4 hours and 109.0 +/- 22.9 mg% in group I, 7.7 +/- 2.3 hours and 98.6 +/- 18.0 mg% in group II, 10.4 +/- 2.9 hours and 96.9 +/- 24.7 mg% in group III, and 12.6 +/- 2.6 hours and 95.7 +/- 20.5 mg% in group IV, respectively. No one in the 230 children had blood glucose less than 40 mg% even in 5 infants who were starved for 12 hours or more. Therefore, we concluded that preoperative starvation is well tolerated than the originally expected in the infants and children. The fasting time before anesthesia can be executed safely even though the operation schedule may not be right on time.
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PMID:Prolonged fasting in pediatric outpatients does not cause hypoglycemia. 830 51

An audit of pre-operative starvation at Huddersfield Royal Infirmary has been undertaken. It shows that both adults and children are starved for significantly longer than the hospital's official starvation policy requires. The mean starvation time for children was almost 10 h, which is longer than the 8 h required before hypoglycaemia becomes a risk. A review of the literature suggests that only 3 h of fluid withdrawal is necessary. Possible ways to improve pre-operative starvation regimens are discussed.
Anaesthesia 1993 Feb
PMID:Audit of pre-operative starvation. 846 Jul 67

The authors measured arterial plasma levels of acetoacetate, 3-hydroxybutyrate, free fatty acid and the blood levels of lactate and glucose to evaluate fat metabolism during isoflurane anesthesia and surgery in twenty patients who ranged in age from 17 to 67 years. They underwent non-abdominal surgery (orthopedic surgery) or abdominal surgery (gastrointestinal or gynecological surgery). The operation started at 9 AM following starvation after 9 PM of the day before surgery. Anesthesia was induced with intravenous thiopental followed by intravenous succinylcholine to facilitate tracheal intubation, and maintained with isoflurane in 50 % nitrous oxide and 50 % oxygen. Vecuronium was given intravenously during surgery. Lactated Ringer's solution at a speed of 5-15 ml.kg-1.h-1 was also administered intravenously throughout the procedures. Patients who had received glucose solution or blood transfusion were excluded. Plasma acetoacetate and 3-hydroxybutyrate levels increased significantly with surgical stimulation in both groups and they were slightly higher in the abdominal group than those in the non-abdominal group. However there was no statistical difference in plasma keton body levels between the groups. Mild increases in plasma free fatty acid and blood lactate levels were detected during surgery in both groups to the same extent. Blood glucose increased significantly during surgery in both groups and the increase was statistically higher in the abdominal group than that in the non-abdominal group. The findings suggest that there is no difference in fat metabolism between non-abdominal and abdominal groups during surgical intervention lasting as long as 3 hours when patients are starved and do not receive any glucose during surgery.
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PMID:[Arterial plasma keton body levels during isoflurane anesthesia and surgery]. 854 88

To determine the effect of rice porridge feeding before elective surgery on preoperative gastric fluid pH, volume and starvation, a prospective study was undertaken in pediatric patients. Twenty healthy children ranged in age from 5 to 12 years were allocated randomly to either a fasted or rice porridge group. The children of fasted group (control group) were allowed to take solid food until midnight before the operation. The rice porridge group (study group) patients received a small amount of rice porridge 5 hours 30 minutes before the induction of anesthesia. The patients of both groups were permitted to take clear fluid until 5 hours before the induction of anesthesia. After the induction of anesthesia, gastric fluid was aspirated through an orogastric tube. The mean gastric fluid volume was 0.43 +/- 0.32 ml.kg-1 in the control group and 0.5 +/- 0.6 ml.kg-1 in the study group. The mean gastric fluid pH was 1.43 +/- 0.27 ml.kg-1 in the control group and 1.89 +/- 0.75 ml.kg-1 in the study group. There were no significant differences between the two groups concerning the gastric fluid volume and pH. The patient of the study group complained of less hunger. Preoperative rice porridge feeding is a possible preoperative feeding for pediatric patients.
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PMID:[Possibility of rice porridge for preoperative feeding in children]. 881 89

Measurement of amino acid kinetics using muscle exchange rates of labeled phenylalanine and leucine has been successfully used to estimate in vivo protein synthesis and degradation rates in human forearm and in hindlimb of large laboratory animals. No good method to measure protein breakdown in muscle of small laboratory animals is available, and we therefore investigated whether this technique can be applied to rats. Using [3H]phenylalanine-exchange measurements, protein synthesis and degradation rates were measured in muscle of fed and 2-day starved rats. Protein synthesis rates obtained in this way were compared with rates measured with the phenylalanine flooding-dose technique in sham-cannulated (including anesthesia and surgery) fed and fasted rats and in awake fed rats. Using the [3H]phenylalanine-exchange method, protein synthesis rates in 2-day starved rats were increased to 292% and protein degradation rates to 217% of the values obtained in fed rats. However, due to a high variation, these changes were not statistically significant. Results obtained with the flooding-dose technique indicate that 2-day starvation reduced protein synthesis rates to 61% of the fed value. However, protein synthesis rates measured with the flooding-dose technique were decreased by 40% in sham-cannulated fed rats in comparison to awake fed rats. An additional 19% reduction in adenosine triphosphate (ATP) concentration in the muscle of the same rats shows that the procedure necessary to apply the exchange measurements to rats has a significant influence on the physiology of the muscle. We therefore conclude that [3H]phenylalanine-exchange measurements as applied in this study are of limited value to estimate in vivo protein synthesis and degradation rates of individual tissues in rats.
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PMID:Tracer kinetics are of limited value to measure in vivo protein synthesis and degradation rates in muscle of anesthesized rats. 884 85

The case of a woman of 27 affected by the Prader-Willi syndrome who underwent general anaesthesia for dental surgery is reported. The patient presented severe mental retardation, small stature, moderate muscular hypotonia, hyperphagia, obesity, and diabetes mellitus. Premedication consisted of diazepam and atropine; anaesthesia was induced with propofol and maintained with propofol, fentanyl and N2O; muscle paralysis was obtained with atracurium. A small glottis was observed at laryngoscopy so that a 6 mm cuffed tube was inserted. Surgery lasted 75 minutes; the patient recovered promptly a few minutes following the end of propofol infusion; no postoperative complication was recorded. As hypoglycemia can occur during and after surgery in the Prader-Willi syndrome, plasma samples for glucose, NEFA, insulin, cortisol, and growth hormone (GH) were collected prior to the induction of anaesthesia (A), 20 minutes after starting surgery (B), at the end of surgery (C), and 3 hours later (D). In spite of the infusion of glucose, hyperglycemia was observed just in C and D samples (A:77; B:88; C:245; D:279 mg/dl). Stable NEFA values, within the normal range, were observed (A:77; B:88; C:245; D:279 mg/dl) suggesting poor or absent lipolysis. Insulin decreased progressively during surgery (A:10.5; B:8.8; C:5.4; D:7.0 mU/L). Cortisol peaked in B (A:9.5; B:20.9; C:13.4; D:4.8 micrograms/dl), suggesting normal hypothalamic reactivity to the surgical stimulus. Finally very low GH levels were observed (A:0.04; B:0.07; C:0.06; D:0.09 ng/ml) suggesting GH deficiency, which had possibly affected the size of patient's glottis. Our data support the hypothesis that hypoglycemia in the Prader-Willi syndrome originates from inadequate lipolysis during starvation.
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PMID:[General anesthesia in Prader-Willi syndrome]. 910 80

We performed prospective study to determine whether the increase of calories with preoperative oral intake will prevent ketosis due to preoperative starvation in children receiving afternoon surgery. Twenty five children (aged 3 to 9 years) for elective minor surgery under general anesthesia with sevoflurane and nitrous oxide were divided into morning surgery group and afternoon surgery group, and the latter was divided into 2 groups according to calories contained in the clear fluid. The calorie of the clear fluid in the afternoon group P was 0.24 kcal.ml-1, and that in the afternoon group A was 0.48 kcal.ml-1. The calorie of the clear fluid in the morning group was 0.48 kcal. ml-1. The levels of blood glucose, blood ketone body, plasma free fatty acids (NEFA), insulin, glucagon and cortisol were measured before and during intravenous infusion in three groups. The urinary catecholamine excretion was measured in the urine collected from 18:00 on the day before operation day until the start of anesthesia. There were no significant differences in the levels of blood glucose, NEFA, insulin, glucagon, cortisol and urinary catecholamine excretion. But the level of blood ketone body only in the afternoon group P was significantly higher than that in the morning group. But the levels of NEFA before infusion were higher than average in 40-60 percent of patients of each group. These data suggest that the increasing preoperative calories with oral intake will prevent ketosis due to preoperative starvation in the afternoon group as well as in the morning group. But the short duration of starvation only can not prevent lipolysis completely.
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PMID:[The effect of calories of preoperative oral intake on the glucose metabolic response in children]. 1033 32

In order to evaluate postoperative nutrition in women who have undergone Caesarean section, we conducted a national survey. Questionnaires were sent to 100 randomly selected obstetric units in the UK, and were completed and returned by senior midwives. We found that that only 21.5% of units had a departmental policy concerning feeding after Caesarean section. Midwives decided when women could eat and drink in the majority of obstetric units (78.5%), often without the help of guidelines. The period of postoperative starvation was found to vary greatly, from < 1 h in some units to > 24 h in others. We suggest that all obstetric units should produce guidelines in order to rationalise postoperative feeding for women following Caesarean section.
Anaesthesia 1999 Mar
PMID:Attitudes to oral feeding following caesarean section. 1041 38

Maintenance of gut mucosal homeostasis depends on a balance between cell proliferation and cell death. Gut mucosal integrity is impaired after severe burn and during starvation. We determined the effect of burn, starvation, and the combination of both on small bowel epithelial apoptosis and proliferation. Fifty adult male Fischer 344 rats (260-300 g) received a 60% full-thickness scald burn and were randomly divided into fed and starved groups. Small intestine was taken at 12, 24, and 48 hr after injury. All animals in the 12-hr group were starved while recovering from anesthesia. Apoptosis was quantified by immunohistochemical staining (TUNEL) and mucosal proliferation was determined by bromodeoxyuridine (BrdU) incorporation. The apoptotic index was higher in burned rats compared to controls at 12 hr after burn; both these groups were starved (P < 0.05). At 24 and 48 hr after burn, apoptosis was highest in the starved groups, with no additional effects of burn (P < 0.05). Mucosal epithelial cell proliferation was not different between groups at any time point. In conclusion, burn and starvation both increase apoptosis in the small bowel mucosa; however, these effects are not additive. Apoptosis could be attenuated by enteral feeding, which delineates the importance of early enteral feeding initiation after injury to maintain mucosal integrity.
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PMID:Burn and starvation increase programmed cell death in small bowel epithelial cells. 1071 61


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