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Perioperative Glucose Control

Seokha Yoo, Ho-Jin Lee, Hannah Lee, Ho-Geol Ryu
BACKGROUND: Glucose control can be difficult in the intraoperative and immediate postoperative period of liver transplantation. Hyperglycemia and glucose variability have been associated with acute kidney injury (AKI) in critically ill patients. We performed a retrospective study to test the hypothesis that perioperative glucose levels represented by time-weighted average glucose levels and glucose variability are independently associated with the incidence of postoperative AKI in patients undergoing liver transplantation...
October 4, 2016: Anesthesia and Analgesia
Xiaofeng Duan, Lei Gong, Xiaobin Shang, Hongjing Jiang, Peng Tang, Zhentao Yu
OBJECTIVE: To study the impact of preoperative fasting plasma glucose(FPG) on postoperative morbidity and outcome following surgical resection of esophageal squamous cell carcinoma (ESCC), and to analyze the risk factor of postoperative complication in ESCC. METHODS: Clinicopathological data of 314 ESCC patients undergoing esophagectomy in our center between January 2011 and December 2012 were retrospectively collected. Patients were divided into two groups according to their preoperative FBG: normal FPG group (FPG<6...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Georgios Antonios Margonis, Neda Amini, Kazunari Sasaki, Yuhree Kim, Katiuscha Merath, Stefan Buettner, Emmanouil Pikoulis, Nikolaos Andreatos, Doris Wagner, Efstathios Antoniou, Timothy M Pawlik
INTRODUCTION: There is limited evidence characterizing the impact of glycemic alterations on short-term outcomes among patients undergoing resection of colorectal liver metastases (CRLM). METHODS: Hyperglycemia was defined as a glucose value >125 mg/dl according to WHO definition. The impact of early postoperative hyperglycemia on short-term postoperative outcomes was assessed. RESULTS: The mean postoperative glucose value was 128 mg/dl; 30 (9...
September 27, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Tsutomu Namikawa, Masaya Munekage, Hiroyuki Kitagawa, Tomoaki Yatabe, Hiromichi Maeda, Yuuki Tsukamoto, Kenichi Hirano, Takuji Asano, Yoshihiko Kinoshita, Kazuhiro Hanazaki
This clinical study aimed to compare a novel and conventional artificial pancreas (AP) used in surgical patients for perioperative glycemic control, with respect to usability, blood glucose measurements, and glycemic control characteristics. From July in 2010 to March in 2015, 177 patients underwent perioperative glycemic control using a novel AP. Among them, 166 patients were eligible for inclusion in this study. Intensive insulin therapy (IIT) targeting a blood glucose range of 80-110 mg/dL was implemented in 82 patients (49 %), and the remaining 84 patients (51 %) received a less-intensive regime of insulin therapy...
September 20, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Wojciech Szychta, Franciszek Majstrak, Grzegorz Opolski, Krzysztof J Filipiak
INTRODUCTION: Strict glucose control is an everyday practice in the perioperative period. Elevated glucose level has a deleterious impact on clinical results, but a therapeutic target has not been stated yet. AIM: To determine a glucose concentration range affecting long-term outcomes after coronary artery bypass surgery (CABG). MATERIAL AND METHODS: This study is a retrospective evaluation of consecutive patients treated in a university hospital in Poland from 2004 to 2008...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Angélica de Fátima de Assunção Braga, Franklin Sarmento da Silva Braga, José Hélio Zen Junior, Maria José Nascimento Brandão, Giancarlo Antonio Marcondes, Thales Daniel Alves Barbosa
: Insulinoma is a functional neuroendocrine tumor derived from beta cells of the pancreatic islets of Langerhans, usually solitary, benign, and curable with surgery (enucleation). It rarely occurs during pregnancy and is clinically manifested by hypoglycemia, particularly in the first trimester of pregnancy. During pregnancy, both conservative therapeutic measures (medication) and surgical treatment are challenging regarding the impossibility of studies on drug teratogenicity as well as the maternal-fetal repercussions during surgery, such as hypoglycemia and changes due to stress...
August 11, 2016: Revista Brasileira de Anestesiologia
W Y Wang
The number of tooth extraction patients with cardiovascular disease in our country is increasing year by year. Safety is essential for those patients and there is no uniform standard of risk assessment and management for tooth extraction patients with cardiovascular disease during perioperative period. By referring to literatures and with the clinical experience, the author summarized the risk assessment methods for tooth extraction patients with cardiovascular disease during perioperative period. Blood pressure control, cardiac function determination, arrhythmia recognition, blood glucose management, oral antiplatelet or anticoagulant medicine use, etc, were proposed in this article...
July 2016: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
James D Capozzi, Eric R Lepkowsky, Marie M Callari, Ellen T Jordan, Jan A Koenig, Gregory H Sirounian
BACKGROUND: Diabetes mellitus has been associated with significant perioperative complications in joint arthroplasty. In addition, many patients are unaware of their dysglycemic status, and the prevalence of undiagnosed dysglycemia in joint arthroplasty patients is unknown. METHODS: Several years ago, we began routine hemoglobin A1c (HbA1c) level screening in all our patients planning to undergo elective total hip and total knee arthroplasties. We retrospectively reviewed the HbA1c levels in our initial 663 patients...
June 23, 2016: Journal of Arthroplasty
Jessica A Zaman, Neil Shah, Glen E Leverson, Jacob A Greenberg, Luke M Funk
BACKGROUND: Bariatric surgery is the most effective treatment for morbidly obese type II diabetics. However, guidelines for perioperative glucose control are not well established. We examined management of perioperative glucose levels in diabetic patients undergoing bariatric surgery and determined the impact of optimal glucose control as defined by the American Society for Metabolic and Bariatric Surgery (ASMBS) on patient outcomes, including long-term diabetes resolution. METHODS: A single-institution, retrospective analysis of 155 morbidly obese diabetic patients who underwent laparoscopic gastric bypass (RYGB) or sleeve gastrectomy (LSG) from 2010 to 2014 was performed...
July 22, 2016: Surgical Endoscopy
Justin Parekh, Garrett R Roll, Steven Wisel, Robert J Rushakoff, Ryutaro Hirose
Recipient diabetes accounts for ~34% of end stage renal disease in patients awaiting renal transplantation and has been linked to poor graft function. We conducted a single center, open label, randomized controlled trial to determine if moderately intense glucose control during allograft reperfusion would reduce the incidence of poor graft function. Adult diabetics undergoing deceased donor renal transplant were randomized to moderately intense glucose control (n=30) or standard control (n=30). The primary outcome was poor graft function (dialysis within seven days of transplant or failure of serum creatinine to fall by 10% for three consecutive days)...
July 16, 2016: Clinical Transplantation
Lukas M Löffel, Fiona C Burkhard, Jukka Takala, Patrick Y Wuethrich
BACKGROUND: Gastrointestinal (GI) complications often delay recovery after radical cystectomy with urinary diversion. The authors investigated if perioperative administration of a potassium-enriched, chloride-depleted 5% glucose solution (G5K) accelerates recovery of GI function. METHODS: This randomized, parallel-group, single-center double-blind trial included 44 consecutive patients undergoing radical cystectomy and pelvic lymph node dissection with urinary diversion...
October 2016: Anesthesiology
Deepanwita Das, Chaitali Sen, Anupam Goswami
INTRODUCTION: Etomidate is usually preferred in the induction of cardiac compromised patients due to its relative cardiovascular stability. However, the use of this drug has been limited as etomidate induces suppression of cortisol biosynthesis as a result of blockade of 11-beta-hydroxylation in the adrenal gland, mediated by the imidazole radical of etomidate. This study was carried out to observe the effect of Vitamin C on adrenal suppression after etomidate induction in patients undergoing cardiac surgery...
July 2016: Annals of Cardiac Anaesthesia
Katsuya Tanaka, Yasuo M Tsutsumi
It is important for the anesthesiologists to understand pathophysiology of perioperative stress hyperglycemia, because it offers strategies for treatment of stress hyperglycemia. The effect of glucose tolerance is different in the choice of the anesthetic agent used in daily clinical setting. Specifically, the volatile anesthetics inhibit insulin secretion after glucose load and affects glucose tolerance. During minor surgery by the remifentanil anesthesia, the stress reaction is hard to be induced, suggesting that we should consider low-dose glucose load...
May 2016: Masui. the Japanese Journal of Anesthesiology
John D Dortch, Dustin L Eck, Beth Ladlie, Sarvam P TerKonda
Perioperative hyperglycemia is a well-known risk factor for surgical morbidity such as wound healing, infection, and prolonged hospitalization. This association has been reported for a number of surgical subspecialties, including plastic surgery. Specialty-specific guidelines have become increasingly available in the literature. Currently, glucose management guidelines for plastic surgery are lacking. Recognizing that multiple approaches exist for perioperative glucose, protocol-based models provide the necessary structure and guidance for approaching glycemic control...
July 2016: Aesthetic Surgery Journal
Kazuhiro Hanazaki, Masaya Munekage, Hiroyuki Kitagawa, Tomoaki Yatabe, Eri Munekage, Mai Shiga, Hiromichi Maeda, Tsutomu Namikawa
The incidence of diabetes is increasing at an unprecedented pace and has become a serious health concern worldwide during the last two decades. Despite this, adequate glycemic control using an artificial pancreas has not been established, although the 21st century has seen rapid developments in this area. Herein, we review current topics in glycemic control for both the wearable artificial pancreas for type 1 and type 2 diabetic patients and the bedside artificial pancreas for surgical diabetic patients. In type 1 diabetic patients, nocturnal hypoglycemia associated with insulin therapy remains a serious problem that could be addressed by the recent development of a wearable artificial pancreas...
September 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
I Hommel, H Wollersheim, C J Tack, J Mulder, P J van Gurp, M E J L Hulscher
AIMS: To assess the impact of a multifaceted strategy to improve perioperative diabetes care throughout the hospital care pathway. METHODS: We conducted a controlled before-and-after study in six hospitals. The purpose of the strategy was to target four predominant barriers that obstruct optimum care delivery. We provided feedback on baseline indicator performance, developed a multidisciplinary protocol and patient information, and provided professional education...
April 17, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Priyankar K Datta, Dilip K Pawar, Dalim K Baidya, Souvik Maitra, Ajisha Aravindan, Maddur Srinivas, Ramakrishnan Lakshmy, Nandita Gupta, Minu Bajpai, Veereshwar Bhatnagar, Sandeep Agarwala
BACKGROUND: Glucose requirement in neonates during surgery and the impact of glucose supplementation on neonatal metabolism remain unclear. AIM: This study was designed to identify an appropriate perioperative fluid regimen in neonates which maintains carbohydrate and lipid homeostasis. METHODS: Forty-five neonates undergoing primary repair of a trachea-esophageal fistula were randomly allocated into three groups. During surgery, the neonates received either 1% dextrose in Ringer lactate (RL) (group D1) at 10 ml·kg(-1) ·h(-1) , or 2% dextrose in RL (group D2) at 10 ml·kg(-1) ·h(-1) , or 10% dextrose in N/5 saline at 4 ml·kg(-1) ·h(-1) and replacement fluid with 6 ml·kg(-1) ·h(-1) of RL (group D4)...
June 2016: Paediatric Anaesthesia
G Yorulmaz, M Cilekar, U Bilge, E Akcan, A Akalin
OBJECTIVES: Our aim was to examine changes in insulin resistance, Carotid Intima-Media Thickness (CIMT), in morbid obese patients without any known associated chronic diseases who underwent sleeve gastrectomy. MATERIALS AND METHODS: The subjects of this study were patients with minimum BMI of 40, who did not have any known chronic diseases. Sleeve gastrectomy was performed and perioperative control endoscopy was performed. The following values were measured before the operation and after follow-up period after the operation: Fasting blood glucose and insulin, lipid profile, BMI, liver function tests, right and left CIMT...
May 2016: Nigerian Journal of Clinical Practice
David J Kusin, Uri M Ahn, Nicholas U Ahn
STUDY DESIGN: A retrospective cohort. OBJECTIVE: The objective of the study was to determine what effect, if any, diabetes has on surgical outcomes in patients with cervical spondylotic myelopathy (CSM). SUMMARY OF BACKGROUND DATA: Diabetes is known to impair healing and has been shown to affect outcomes in lumbar surgery, but few studies have assessed outcomes in cervical surgery, and cervical myelopathy in particular. METHODS: The records of 113 patients operated on by one surgeon were reviewed...
September 15, 2016: Spine
Yong Guo, Peiyu Jia, Junfeng Zhang, Xuemin Wang, Hong Jiang, Wei Jiang
OBJECTIVE: To explore the risk factors associated with postoperative delirium (PD) in elderly patients following total hip arthroplasty (THA) for hip fracture. METHODS: This prospective study enrolled elderly patients (≥ 65 years) with hip fractures who underwent THA under general anaesthesia, and who had a complete set of postoperative observations. Detailed medical history and perioperative characteristics were recorded. During the postoperative period, patients were assessed twice daily for PD using the Confusion Assessment Method...
April 2016: Journal of International Medical Research
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