Does nitrate supplementation improve CPX performance / postop recovery
Research type
Research Study
Full title
Does dietary nitrate supplementation improve performance in cardiopulmonary exercise testing and post-operative recovery in patients with colorectal cancer
IRAS ID
163841
Contact name
Vanessa Brown
Contact email
Sponsor organisation
Royal Surrey County Hospital Foundation Trust
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 4 months, 4 days
Research summary
Dietary nitrate supplementation has been shown to improve exercise tolerance and performance in professional athletes and physically active males. The mechanism of action by which this occurs is unclear.
Cardiopulmonary exercise testing (CPX) is an established, non invasive and safe method of assessing patients’ combined heart and lung function prior to surgery. It has been shown to predict complications and length of stay in patients undergoing major elective surgery.
Undergoing major surgery is like running a marathon - extra demands are placed on the body and oxygen demands increase.
The anaerobic threshold (AT) is the oxygen uptake (VO2) at which the bodies demand for energy becomes so high that the cycle to produce energy has to be supplemented by other processes which do not use oxygen (anaerobic metabolism). Both values are calculated during CPX and have been shown to predict short and long term outcomes after surgery and postoperative complications. Both have no volitional component so are not possible to alter by trying harder or pretending to be exhausted. Patients with colorectal cancer have been shown to have a lower AT which increases significantly after the cancer is removed.
This study aims to see if outcomes after laparoscopic colorectal surgery can be improved by determining if nitrate loading with beetroot juice improves the AT and Peak VO2 in patients with colorectal cancer and decreases the rate of post-operative complications.
Patients will follow the standard post-operative enhanced recovery care pathway for all colorectal patients.
Standard post-operative measurements will be recorded including:
• Daily temperature, blood pressure, heart rate and saturations
• Time until patient actually leaves the hospital
• The incidence of readmissionsThe following addition information will be collected during the patients hospital stay;
• grip test will be recorded twice daily until patient discharge
• Time until patient is able to tolerate a normal diet
• Time until patient is able to pass flatus
• Time until patient is able to open their bowels
• Time until patient is deemed medically fit for dischargeREC name
London - Surrey Research Ethics Committee
REC reference
15/LO/0945
Date of REC Opinion
17 Jul 2015
REC opinion
Further Information Favourable Opinion