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Perioperative Glucose Control

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https://www.readbyqxmd.com/read/29722910/glycemic-management-in-the-bariatric-surgery-population-a-review-of-the-literature
#1
Meredith L Howard, Taylor D Steuber, Sarah A Nisly
Obesity is a worldwide epidemic often complicated by multiple comorbidities, including type 2 diabetes mellitus (T2DM). Bariatric surgery is an increasingly common and effective weight loss strategy for obese patients that may result in resolution of metabolic related disease states, such as T2DM. Although bariatric surgery has many positive outcomes for patients, dietary and pathophysiologic changes can create difficult to control blood glucose, especially in the immediate perioperative setting. Depending on oral antidiabetic agent and insulin needs preoperatively, many patients require cessation of oral agents and reduction or cessation of insulin...
May 3, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29685019/effect-of-branched-chain-amino-acids-on-perioperative-temperature-glucose-level-and-fat-metabolism-in-patients-with-gastrointestinal-tumors
#2
L Y Wen, Y S Zhang, X Zhou, G Li, C Y Hu, Y Li, L J Jin
This study aimed to investigate the effect of branched chain amino acids (BCCAs) on perioperative temperature, glucose and fat metabolism in patients with gastrointestinal tumors. Fifty-six patients undergoing gastrointestinal tumor surgery were included in the study and randomly divided into two groups of 28 patients each: an experimental and a control group. During surgery, the experimental group received 5.64mL·Kg-1·h-1(4KJ·Kg-1·h-1) of BCCAs intravenously, through an infusion pump, and the control group received an equal volume of NaCl 0...
March 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29683136/continuous-glucose-monitoring-in-the-cardiac-icu-current-use-and-future-directions
#3
Laura A Scrimgeour, Brittany A Potz, Frank W Sellke, M Ruhul Abid
Perioperative glucose control is highly important, particularly for patients undergoing cardiac surgery. Variable glucose levels before, during and after cardiac surgery lead to increased post-operative complications and patient mortality. [1] Current methods for intensive monitoring and treating hyperglycemia in the Intensive Care Unit (ICU) usually involve hourly glucose monitoring and continuous intravenous insulin infusions. With the advent of more accurate subcutaneous glucose monitoring systems, the role of improved glucose control with newer systems deserves consideration for widespread adoption...
November 2017: Clinical medicine research
https://www.readbyqxmd.com/read/29652278/effects-of-glargine-insulin-on-glycemic-control-in-patients-with-diabetes-mellitus-type-ii-undergoing-off-pump-coronary-artery-bypass-graft
#4
Hemang Gandhi, Alpesh Sarvaia, Amber Malhotra, Himanshu Acharya, Komal Shah, Jeevraj Rajavat
Background: The prevalence of diabetes mellitus in patients requiring coronary artery bypass grafting (CABG) is noticeably high (20%-30%). These patients have inferior perioperative outcome, reduced long-term survival, and high risk of recurrent episodes of angina. To improve perioperative outcome surgical unit defined satisfactory glycemic control is desired during this period. Hence, the aim of our study is to compare the efficacy of glargine insulin combination with continuous human insulin infusion for perioperative glycemic control in patients with diabetes undergoing CABG...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29628827/a-prospective-randomized-study-on-the-impact-of-low-dose-dexamethasone-on-perioperative-blood-glucose-concentrations-in-diabetics-and-nondiabetics
#5
Athul M Purushothaman, Vinayak Seenappa Pujari, Nalini B Kadirehally, Yatish Bevinaguddaiah, Pratheek R Reddy
Background: Dexamethasone is a potent corticosteroid when administered alone or in combination alone has proven efficacious in preventing nausea and vomiting (PONV) perioperatively. However, the administration of even a single dose has been associated with hyperglycemia. This is the first study that evaluates the effect of two low-doses of dexamethasone (4 and 8 mg) on blood glucose concentrations among diabetics and nondiabetics in patients who have received spinal anesthesia. Materials and Methods: After obtaining ethical clearance and patient consent, 180 American Society of Anesthesiologists 1-3 patients undergoing the elective infraumbilical surgeries under spinal anesthesia aged between 18 and 70 years were included in this study...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29605149/inadequate-glycemic-control-is-associated-with-increased-surgical-site-infection-in-total-joint-arthroplasty-a-systematic-review-and-meta-analysis
#6
Noam Shohat, Khitam Muhsen, Ron Gilat, Alexander J Rondon, Antonia F Chen, Javad Parvizi
BACKGROUND: The association between inadequate glycemic control and surgical site infection (SSI) following total joint arthroplasty (TJA) remains unclear. The aim of this study is to assess the relationship between perioperative glycemic control and the risk for SSI, mainly periprosthetic joint infection. METHODS: We searched OVID-MEDLINE, Embase, and Web of Science from inception up to June 2017. The main independent variable was glycemic control as defined by glycated hemoglobin (HbA1C) or perioperative glucose values...
February 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29599083/corrigendum-to-the-effect-of-perioperative-glucose-control-on-postoperative-insulin-resistance-clin-nutr-31-5-2012-676-681
#7
Christina Blixt, Christian Ahlstedt, Olle Ljungqvist, Bengt Isaksson, Sigridur Kalman, Olav Rooyackers
No abstract text is available yet for this article.
March 23, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29589415/perioperative-hyperglycaemia-and-neurocognitive-outcome-after-surgery-a-systematic-review
#8
Jeroen Hermanides, Ega Qeva, Benedikt Preckel, Federico Bilotta
BACKGROUND: Preliminary evidence suggest a possible relationship between perioperative hyperglycaemia, postoperative delirium (POD) or cognitive dysfunction (POCD). We aim to present the available clinical evidence related to chronic (i.e. Diabetes Mellitus) or acute perioperative hyperglycaemia as risk factors for POD/POCD. METHODS: A literature search of EMBASE (via Ovid, 1974-present) online medical database and MEDLINE (via PubMed or Ovid, 1946-present) was performed...
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29576485/preoperative-glycemic-control-predicts-perioperative-serum-glucose-levels-in-patients-undergoing-total-joint-arthroplasty
#9
Brian M Godshaw, Connor A Ojard, Tyler M Adams, George F Chimento, Alaa Mohammed, Bradford S Waddell
BACKGROUND: Diabetic patients undergoing total joint arthroplasty (TJA) with postoperative hyperglycemia >200 mg/dL have increased the risk of prosthetic joint infection (PJI). We investigated the correlation between preoperative hemoglobin A1c (A1c) and postoperative hyperglycemia in diabetic patients undergoing TJA. METHODS: A retrospective review of 773 diabetic patients undergoing TJA was conducted. A Youden's J computational analysis determined the A1c where postoperative glucose levels >200 mg/dL were statistically more likely...
February 26, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29559406/working-party-approved-by-the-french-society-of-anaesthesia-and-intensive-care-medicine-sfar-and-the-french-society-for-the-study-of-diabetes-sfd
#10
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) levels, and to adjust any treatments accordingly before surgery, paying particular attention to specific complications of diabetes. Gastroparesis creates a risk of stasis and aspiration of gastric content at induction of anaesthesia requiring the use of a rapid sequence induction technique. Cardiac involvement can be divided into several types...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29557378/neuroprotective-effect-of-bispectral-index-guided-fast-track-anesthesia-using-sevoflurane-combined-with-dexmedetomidine-for-intracranial-aneurysm-embolization
#11
Chao-Liang Tang, Juan Li, Zhe-Tao Zhang, Bo Zhao, Shu-Dong Wang, Hua-Ming Zhang, Si Shi, Yang Zhang, Zhong-Yuan Xia
Dexmedetomidine has sedative, anxiolytic, analgesic, anti-sympathetic, and anti-shivering effects. Dexmedetomidine might be effective in combination with sevoflurane for anesthesia, but prospective randomized controlled clinical trials with which to verify this hypothesis are lacking. In total, 120 patients who underwent embolization of an intracranial aneurysm were recruited from Anhui Provincial Hospital and Renmin Hospital of Wuhan University of China and randomly allocated to two groups. After intraoperative administration of 2% to 3% sevoflurane inhalation, one group of patients received pump-controlled intravenous injection of 1...
February 2018: Neural Regeneration Research
https://www.readbyqxmd.com/read/29555546/specific-situations
#12
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
Ambulatory surgery can be carried out in diabetic patients. By using a strict organisational and technical approach, the risk of glycaemic imbalance is minimised, allowing the patients to return to their previous way of life more quickly. Taking into account the context of ambulatory surgery, with a same day discharge, the aims are to minimise the changes to antidiabetic treatment, to maintain adequate blood sugar control and to resume oral feeding as quickly as possible. The preoperative evaluation is the same as for a hospitalised patient and recent glycaemic control (HbA1c) is necessary...
March 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29521742/antibiotic-induced-disruption-of-intestinal-microbiota-contributes-to-failure-of-vertical-sleeve-gastrectomy
#13
Cyrus Jahansouz, Christopher Staley, Scott Kizy, Hongliang Xu, Ann V Hertzel, Jessi Coryell, Stephanie Singroy, Matthew Hamilton, Meri DuRand, David A Bernlohr, Michael J Sadowsky, Alexander Khoruts, Sayeed Ikramuddin
OBJECTIVE: The aim of this study was to test whether the perioperative composition of intestinal microbiota can contribute to variable outcomes following vertical sleeve gastrectomy (VSG). SUMMARY OF BACKGROUND DATA: Although bariatric surgery is the most effective treatment for obesity, metabolic outcomes are variable. METHODS: Diet-induced obese mice were randomized to VSG or sham surgery, with or without exposure to antibiotics that selectively suppress mainly gram-positive (fidaxomicin, streptomycin) or gram-negative (ceftriaxone) bacteria on postoperative days (POD) 1-4...
March 8, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29512047/perioperative-hyperglycemia-an-unmet-need-within-a-surgical-site-infection-bundle
#14
M Gachabayov, A J Senagore, S K Abbas, S B Yelika, K You, R Bergamaschi
BACKGROUND: The aim of this study was to determine whether perioperative stress hyperglycemia is correlated with surgical site infection (SSI) rates in non-diabetes mellitus (DM) patients undergoing elective colorectal resections within an SSI bundle. METHODS: American College of Surgeons National Surgical Quality Improvement Program data of patients treated at a single institution in 2006-2012 were supplemented by institutional review board-approved chart review...
March 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29457119/effects-of-glucose-insulin-infusion-during-major-oral-and-maxillofacial-surgery-on-postoperative-complications-and-outcomes
#15
Akina Tohya, Atsushi Kohjitani, Sachi Ohno, Kaoru Yamashita, Yozo Manabe, Mitsutaka Sugimura
Background: Secretion of hormones, which antagonize the action of insulin, is facilitated in response to surgery, and acute resistance to the action of insulin develops. Our aim is to elucidate the effects of intraoperative glycemic control by glucose-insulin (GI) infusion on postoperative complications and outcomes in major oral and maxillofacial surgery. Findings: Thirty patients aged ≥ 60 years undergoing a radical operation of oral malignant tumors with tissue reconstruction (≥ 8 h) were analyzed...
2018: JA Clinical Reports
https://www.readbyqxmd.com/read/29440113/effect-of-a1c-and-glucose-on-postoperative-mortality-in-noncardiac-and-cardiac-surgeries
#16
Willem van den Boom, Rebecca A Schroeder, Michael W Manning, Tracy L Setji, Gic-Owens Fiestan, David B Dunson
OBJECTIVE: Hemoglobin A1c (A1C) is used in assessment of patients for elective surgeries because hyperglycemia increases risk of adverse events. However, the interplay of A1C, glucose, and surgical outcomes remains unclarified, with often only two of these three factors considered simultaneously. We assessed the association of preoperative A1C with perioperative glucose control and their relationship with 30-day mortality. RESEARCH DESIGN AND METHODS: Retrospective analysis on 431,480 surgeries within the Duke University Health System determined the association of preoperative A1C with perioperative glucose (averaged over the first 3 postoperative days) and 30-day mortality among 6,684 noncardiac and 6,393 cardiac surgeries with A1C and glucose measurements...
April 2018: Diabetes Care
https://www.readbyqxmd.com/read/29407052/perioperative-management-of-hyperglycemia-and-diabetes-in-cardiac-surgery-patients
#17
REVIEW
Rodolfo J Galindo, Maya Fayfman, Guillermo E Umpierrez
Perioperative hyperglycemia is common after cardiac surgery, reported in 60% to 90% of patients with diabetes and in approximately 60% of patients without history of diabetes. Many observational and prospective randomized trials in critically-ill cardiac surgery patients support a strong association between hyperglycemia and poor clinical outcome. Despite ongoing debate about the optimal glucose target, there is strong agreement that improved glycemic control reduces perioperative complications.
March 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29356912/current-status-and-issues-of-the-artificial-pancreas-abridged-english-translation-of-a-special-issue-in-japanese
#18
REVIEW
Tsutomu Namikawa, Masaya Munekage, Tomoaki Yatabe, Hiroyuki Kitagawa, Kazuhiro Hanazaki
Surgical stress induces hyperglycemia and gives rise to glucose toxicity, which causes infectious diseases, resulting in unfavorable surgical outcomes. Intensive insulin treatment can control short- and long-term complications in patients with not only diabetes mellitus, but also surgical diabetes; however, it is associated with an increased risk of hypoglycemia. The wearable artificial pancreas was originally developed to control glucose levels in patients with type 1 diabetes, progressing to a device with enhanced stability and safety for these patients...
January 22, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29330638/predictors-of-severe-postoperative-hyperglycemia-after-cardiac-surgery-in-infants-a-single-center-retrospective-observational-study
#19
Natsuhiro Yamamoto, Tomoya Irie, Shunsuke Takaki, Osamu Yamaguchi, Takahisa Goto
PURPOSE: Hyperglycemia is a common issue in infants after cardiac surgery for congenital heart disease. Poor glycemic control is suspected to be associated with adverse postoperative outcomes. This study was performed to investigate clinical factors contributing to hyperglycemia in the perioperative period in infats. METHODS: A total of 69 infants (aged 1-12 months) who were admitted to Yokohama City University Hospital Intensive Care Unit (ICU) after surgical repair of congenital heart diseases with cardiopulmonary bypass (CPB) were retrospectively analysed...
April 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29310400/clinical-analysis-of-hyperkalemia-after-esophagectomy-a-case-report
#20
Qiang Chen, Wei-Guo Zhang, Shu-Chang Chen
RATIONALE: The occurrence of hyperkalemia after esophagectomy is clinically rare. Patients who underwent esophagectomy often have a serum potassium level due to perioperative reduced intake, fluids loss, consumption and other reasons. These patients often require the artificial administration of potassium. Rapid fluid loss and physiological consumption lead to the deficiency of potassium, even hypokalemia. Patients often require the addition of a large amount of potassium after operation...
December 2017: Medicine (Baltimore)
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