Clinical Nutrition Department Leads the Promotion of New ERAS Practice – "An Shu Yin" Aids Surgical

Clinical Nutrition Department Leads the Promotion of New ERAS Practice – "An Shu Yin" Aids Surgical Patients in Accelerated Recovery

With the deep advancement of the Enhanced Recovery After Surgery (ERAS) concept in hospitals at all levels across the country, perioperative nutritional management has become a key link in improving medical quality and patient outcomes. Our hospital’s Clinical Nutrition Department has actively responded and taken initiative, collaborating with multiple surgical departments such as Gastric Surgery, Gastrointestinal Surgery, Gynecology, Bone and Soft Tissue Surgery, Abdominal Surgery, and Breast Surgery to pioneer the hospital-wide promotion of preoperative oral intake of a 12.5% carbohydrate solution—named "An Shu Yin" by our hospital. This provides scientific metabolic preparation support for patients and helps elevate the entire ERAS management process to a new level.

What is "An Shu Yin"? Why Drink "An Shu Yin"?

For a long time, "preoperative fasting for more than 8 hours" has been regarded as an iron rule to prevent anesthesia-related aspiration. However, prolonged fasting not only causes discomfort such as thirst, hunger, and anxiety in patients but also leads to increased insulin resistance, glycogen depletion, and increased protein breakdown, which in turn exacerbates surgical stress responses and is detrimental to postoperative recovery.

"An Shu Yin" is a specialized surgical nutritional drink formulated by our hospital’s Clinical Nutrition Department based on the latest international ERAS guidelines. Its main ingredient is easily absorbable maltodextrin. It is isotonic, residue-free, and has a mild taste, allowing for rapid absorption in a short time and effectively improving the metabolic disorders caused by traditional fasting.

"An" signifies safety and peace of mind;

"Shu Yin" is a nutritional drink specifically designed for the surgical period.

—"An Shu Yin" makes preoperative waiting more comfortable and postoperative recovery faster!

Scientific Mechanism: One Cup of "An Shu Yin," Multiple Benefits

Clinical research shows that preoperative oral intake of "An Shu Yin" offers the following four core benefits:

✅ Reduces Insulin Resistance: Preoperative carbohydrate supplementation activates insulin signaling pathways, reducing the risk of postoperative hyperglycemia, which is particularly beneficial for diabetic patients.

✅ Protects Muscle Protein: Prevents the body from breaking down muscle for energy during fasting, reducing postoperative muscle loss and maintaining good physical condition.

✅ Maintains Liver Glycogen Reserves: Increases liver energy reserves by over 50%, providing an immediate energy source for surgical stress.

✅ Improves Patient Experience: Significantly alleviates preoperative thirst, hunger, and anxiety, enhancing patient satisfaction and compliance.

Note: Multiple RCT studies confirm that patients using preoperative carbohydrate loading experience an average reduction of 8–12 hours in the time to first postoperative flatus, a decrease in the incidence of nausea and vomiting, and a shorter hospital stay.

Standardized Process: "Two-Time Drinking" Ensures Safety and Efficiency

According to the "Chinese Expert Consensus on Perioperative Nutritional Support in Enhanced Recovery After Surgery (2019)" and ASA guidelines, our hospital has established a standardized "An Shu Yin" implementation plan:

10 hours before surgery: Oral intake of 800ml "An Shu Yin"

2 hours before surgery: Oral intake of 400ml "An Shu Yin"

This plan has been clinically verified to ensure rapid gastric emptying (basically emptied within 2 hours), does not affect anesthesia safety, and meets aspiration prevention requirements (gastric content <25ml, pH >2.5).

Note: It is temporarily not applicable for patients with gastric emptying disorders, emergency surgeries, severe reflux esophagitis, etc., and should be decided by the attending physician after evaluation.

Promotion Progress: Implemented in Multiple Surgical Wards

Since its launch in early August 2025, the "An Shu Yin" project has been firstly promoted and applied in ERAS pathway-mature departments such as Gastric Surgery, Gastrointestinal Surgery, Gynecology, Bone and Soft Tissue Surgery, Bone and Rehabilitation, Breast Surgery, and Hepatobiliary Surgery. As of now, over 100 elective surgery patients have successfully completed the "An Shu Yin" preoperative nutritional intervention. Patients generally feedback that "they no longer have to go into the operating room on an empty stomach" and "feel much better mentally."

Meanwhile, the Clinical Nutrition Department, in collaboration with various surgical departments and the Nursing Department, has conducted specialized training to ensure closed-loop management of the entire process, from medical order issuance, drink distribution, patient education, to drinking records. Nursing stations are equipped with "An Shu Yin" usage process and promotional table cards, and responsible nurses provide one-on-one guidance to patients on the correct drinking time and precautions, ensuring standardized and safe implementation.

Nutrition is Treatment, We Are in Action

"An Shu Yin" is not only a product name but also a concrete reflection of our hospital’s patient-centered service philosophy and an important step for the Clinical Nutrition Department to move from "behind-the-scenes support" to "front-end intervention."

In the future, we will continue to expand the application scenarios of "An Shu Yin," explore its value in elderly patients, high-risk malnourished populations, and day surgeries, and establish a multidisciplinary collaboration mechanism with the Anesthesiology Department and operating room to promote the formation of a standardized ERAS nutrition pathway with our hospital’s characteristics.

Introduction to the Clinical Nutrition Department

The Clinical Nutrition Department, as an important component of the modern medical system, originates from a profound understanding of the relationship between food and health. After years of development, it has gradually evolved from simple dietary advice into a comprehensive discipline integrating prevention, diagnosis, and treatment. Its main responsibility is to use nutritional knowledge, combined with clinical medical practice, to provide patients with personalized nutritional assessments, consultations, and nutritional intervention plans. Its goal is to improve patients' nutritional status, promote disease recovery, and enhance quality of life through scientific nutritional intervention methods.

Since its establishment, the Clinical Nutrition Department of Gansu Wuwei Cancer Hospital, under the guidance of hospital leadership and with the support of all hospital departments, has continuously improved its business capabilities and service levels. It has become the leading unit of the Oncology Nutrition Branch of the Gansu Nutrition Society and was added as a national pilot unit for clinical nutrition department construction in 2023. The department team currently has 4 staff members, including 1 chief nutritionist, 1 attending physician, and 2 nutrition nurses. The Clinical Nutrition Department provides professional services and strong support for promoting patient disease recovery and health with a high sense of responsibility and enthusiasm.

The main services currently carried out by the department include: formulating individualized parenteral and enteral nutrition treatment plans, preparing enteral nutrition formulations, and conducting nutrition education.

Formulating Individualized Nutrition Treatment Plans: According to national standards, establish a standardized screening-assessment-diagnosis-treatment nutrition intervention process, carry out nutrition risk screening, nutritional status assessment, malnutrition diagnosis, and dietary guidance for inpatients. Participate in nutrition consultations for inpatients, guide the formulation of enteral and parenteral nutrition treatment plans based on patient conditions, and cooperate with attending physicians to evaluate the clinical effects of nutrition therapy.

Preparation of Enteral Nutrition Formulations: The department has established a enteral nutrition preparation room with a certain scale of 300,000-level cleanliness, equipped with water purification equipment. It can prepare various oral and nasogastric nutrition solutions according to the nutritional metabolic characteristics and needs of different patients, achieving individualized enteral nutrition preparation to meet various clinical nutrition treatment needs.

Nutrition Education: Adhering to the "health-centered" concept, the Clinical Nutrition Department strengthens communication with clinical department medical staff and patients, actively providing scientific and reasonable nutrition treatment, dietary guidance, and nutrition education for patients and the public. It further popularizes scientific nutrition knowledge and also carries out health education activities through various forms such as community nutrition clinics, distribution of healthy diet education materials, and health science lectures, allowing the public to acquire correct nutrition knowledge, reasonably guiding them to establish correct dietary concepts, improving public nutrition health literacy, and contributing to the national "Health for All" goal.

Nutrition Clinic: In the future, it will carry out nutrition consultations, nutrition training, and nutrition health education for various populations, as well as inspection items such as body composition analysis and energy metabolism measurement. It will be responsible for body composition and nutrition metabolism measurements for physical examination populations, outpatients, and inpatients, accurately assessing patients' nutritional status. It will provide scientific and reasonable dietary treatment plans, nutrition guidance, and nutrition knowledge popularization for the public needing weight gain or loss, and patients with disease needs (such as liver disease, diabetes, obesity, gout, etc.). At the same time, it will provide tube-fed patients with home feeding nutrition formulations and offer consultations and education on home feeding.

In the future, we will continue to deepen clinical nutrition services, expand business areas, and provide more comprehensive and professional nutrition services for patients. We believe that with the continuous development and improvement of the Clinical Nutrition Department, we will certainly bring health and hope to more patients.

Director Jiang Xiaoping