Read by QxMD icon Read

Perioperative glycemic control

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 Clin Rep
Rachel C Wolfe
No abstract text is available yet for this article.
February 13, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Adam B King, Clark D Kensinger, Yaping Shi, Matthew S Shotwell, Seth J Karp, Pratik P Pandharipande, J Kelly Wright, Liza M Weavind
BACKGROUND: Liver transplant recipients continue to have high perioperative resource utilization and prolonged length of stay despite improvements in perioperative care. Enhanced recovery pathways have been shown in other surgical populations to produce reductions in hospital resource utilization. METHODS: A prospective, observational study was performed to examine the effect of an enhanced recovery pathway for postoperative care after liver transplantation. Outcomes from patients undergoing liver transplantation from November 1, 2013, to October 31, 2014, managed by the pathway were compared to transplant recipients from the year before pathway implementation...
February 9, 2018: Anesthesia and Analgesia
Yosuke Nakadate, Hiroaki Sato, Tamaki Sato, Takumi Codere-Maruyama, Takashi Matsukawa, Thomas Schricker
PURPOSE: Taking into account the previously described link between body weight and diabetes mellitus (DM) in non-surgical patients, and the understanding that the degree of intraoperative insulin resistance is a predictor of adverse clinical outcomes, we investigated the relationship between body mass index (BMI) and insulin sensitivity during cardiac surgery. METHODS: We prospectively enrolled 400 patients scheduled for elective cardiac surgery and divided them into groups based on the presence or absence of type-2 DM...
February 12, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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
Jourdan M Cancienne, Mark D Miller, James A Browne, Brian C Werner
PURPOSE: To determine the association between glycemic control and infection following knee arthroscopy, and to determine the clinical utility of a threshold HbA1c level. METHODS: A national database identified patients who underwent knee arthroscopy from 2007 to 2016. Patients with concomitant open portions, more complex knee procedures, procedures performed for infection and patients with prior septic knee arthritis were excluded. Patients with an HbA1c level checked within 3 months of surgery were compared to control groups of nondiabetics and diabetics undergoing knee arthroscopy without a perioperative HbA1c...
February 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Hassan Al-Thani, Moamena El-Matbouly, Maryam Al-Sulaiti, Noor Al-Thani, Mohammed Asim, Ayman El-Menyar
We hypothesized that perioperative HbA1c influenced the pattern and outcomes of lower extremity amputation (LEA). A retrospective analysis was conducted for all patients who underwent LEA between 2000 and 2013. Patients were categorized into 5 groups according to their perioperative HbA1c values [Group 1 (<6.5%), Group 2 (6.5-7.4%), Group 3 (7.5-8.4%), Group 4 (8.5-9.4%) and Group 5 (≥9.5%)]. We identified 848 patients with LEA; perioperative HbA1c levels were available in 547 cases (Group 1: 18.8%, Group 2: 17...
January 22, 2018: Current Vascular Pharmacology
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
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...
January 12, 2018: Journal of Anesthesia
Brian C Werner, Victor A Teran, Jourdan Cancienne, D Nicole Deal
BACKGROUND: The primary goal of the study was to evaluate the association of hemoglobin A1c (HbA1c) levels in diabetic patients with the incidence of surgical site infection (SSI) following open carpal tunnel release (CTR). Our secondary objective was to calculate an HbA1c level in diabetic patients that predicted SSI after open CTR. METHODS: A national private-payer insurance database was queried for patients who underwent open CTR using Current Procedural Terminology (CPT) code 64721...
December 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
Gui-Zhen Yang, Fu-Shan Xue, Chao Wen, Ya-Yang Liu
No abstract text is available yet for this article.
March 2018: Journal of Trauma and Acute Care Surgery
Giovanni Landoni, Vladimir Lomivorotov, Simona Silvietti, Caetano Nigro Neto, Antonio Pisano, Gabriele Alvaro, Ludmilla Abrahao Hajjar, Gianluca Paternoster, Hynek Riha, Fabrizio Monaco, Andrea Szekely, Rosalba Lembo, Nesrin A Aslan, Giovanni Affronti, Valery Likhvantsev, Cristiano Amarelli, Evgeny Fominskiy, Martina Baiardo Redaelli, Alessandro Putzu, Massimo Baiocchi, Jun Ma, Giuseppe Bono, Valentina Camarda, Remo Daniel Covello, Nora Di Tomasso, Miriam Labonia, Carlo Leggieri, Rosetta Lobreglio, Giacomo Monti, Paolo Mura, Anna Mara Scandroglio, Daniela Pasero, Stefano Turi, Agostino Roasio, Carmine D Votta, Emanuela Saporito, Claudio Riefolo, Chiara Sartini, Luca Brazzi, Rinaldo Bellomo, Alberto Zangrillo
OBJECTIVE: A careful choice of perioperative care strategies is pivotal to improve survival in cardiac surgery. However, there is no general agreement or particular attention to which nonsurgical interventions can reduce mortality in this setting. The authors sought to address this issue with a consensus-based approach. DESIGN: A systematic review of the literature followed by a consensus-based voting process. SETTING: A web-based international consensus conference...
February 2018: Journal of Cardiothoracic and Vascular Anesthesia
Faisal Jehan, Muhammad Khan, Joseph V Sakran, Mohammad Khreiss, Terence O'Keeffe, Albert Chi, Narong Kulvatunyou, Arpana Jain, El Rasheid Zakaria, Bellal Joseph
BACKGROUND: Plasma hemoglobin A1c (HbA1c) reflects quality of glucose control in diabetic patients. Literature reports that patients undergoing surgery with an elevated HbA1c level are associated with increased postoperative morbidity and mortality. The aim of our study was to evaluate the impact of HbA1c level on outcomes after emergency general surgery (EGS). METHODS: We performed a 3-year analysis of our prospectively maintained EGS database. Patients who had HbA1c levels measured within 3 months before surgery were included...
January 2018: Journal of Trauma and Acute Care Surgery
Danielle M Diemer, Karen L Terry, Melissa Matthews, Ellen Romich, Heather Saran, M Cecilia Lansang
Though insulin dose reduction months after surgery is well-studied, there are limited data on immediate post-operative changes. OBJECTIVES: 1) To determine perioperative glycemic control in patients with type 2 diabetes (DM) on insulin who have undergone Roux-en-Y gastric bypass, and 2) to compare pre- and post-operative insulin regimens and dosage in these patients. RESEARCH DESIGN AND METHODS: A retrospective chart review was conducted on patients with type 2 DM, on insulin, who underwent Roux-en-Y bariatric surgery...
October 11, 2017: Endocrine Practice
Hironori Hayashi, Hiroyuki Takamura, Ryosuke Gabata, Isamu Makino, Yoshinao Ohbatake, Shinichi Nakanuma, Tomoharu Miyashita, Hidehiro Tajima, Kazuhiro Hanazaki, Tetsuo Ohta
BACKGROUND We investigated the impact of using an artificial pancreas for glycemic control in liver transplant recipients. MATERIAL AND METHODS Between January 2014 and December 2016, glycemic control using an artificial pancreas was performed 13 times. The target blood glucose level was set at 80-110 mg/dL. We retrospectively analyzed the clinical course, including achievement rate of the target blood glucose range. RESULTS For perioperative glycemic control, an artificial pancreas was used 9 times. The total insulin dose and achievement rate of the target blood glucose level were 113...
October 3, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
A H Hulst, J A W Polderman, E Ouweneel, A J Pijl, M W Hollmann, J H DeVries, B Preckel, J Hermanides
Historically, metformin was withheld before surgery for fear of metformin-associated lactic acidosis. Currently, however, this risk is deemed to be low and guidelines have moved towards the continuation of metformin. We hypothesized that continuing metformin peri-operatively would lower postoperative serum glucose level without an effect on plasma lactate levels. We performed a single-blind multicentre randomized controlled trial in people with type 2 diabetes mellitus scheduled for non-cardiac surgery and continued (MF+ group) or withheld (MF- group) metformin before surgery...
September 20, 2017: Diabetes, Obesity & Metabolism
Judson B Williams, Eric D Peterson, Álvaro S Albrecht, Shuang Li, Sameer A Hirji, T Ferguson, Peter K Smith, Renato D Lopes
PURPOSE: Critically ill patients with hyperglycemia have worse prognosis. The degree to which glycemic control is achieved following CABG surgery and the association with clinical outcomes is not well understood. MATERIALS AND METHODS: We studied patients undergoing higher risk CABG surgery at 55 US hospitals. Good glycemic control was defined as 70-180mg/dL in the first 24h postoperatively. Generalized estimating equations logistic regression models were used to assess the relationship between glycemic control and clinical outcomes after adjusting for baseline characteristics...
December 2017: Journal of Critical Care
Rajesh Garg, Shelley Hurwitz, Raquel Rein, Brooke Schuman, Patricia Underwood, Shreya Bhandari
AIM: This study was conducted to evaluate the effect of continued follow-up by a hospital diabetes team on HbA1c at 1-year after discharge. METHODS: Adults with HbA1c ≥8% (64mmol/mol), undergoing an elective surgery, were treated in the perioperative period and randomized to continued care (CC) or the usual care (UC) after discharge. Patients in the CC group received weekly to monthly phone calls from a diabetes specialist nurse practitioner (NP) to review their home blood glucose values, diet, exercise, and medications...
August 24, 2017: Diabetes Research and Clinical Practice
Shipra Arya, Zachary O Binney, Anjali Khakharia, Chandler A Long, Luke P Brewster, Peter W Wilson, William D Jordan, Yazan Duwayri
OBJECTIVE: Diabetes and peripheral arterial disease (PAD) are independently associated with increased risk of amputation. However, the effect of poor glycemic control on adverse limb events has not been studied. We examined the effects of poor glycemic control (high hemoglobin A1c level) on the risk of amputation and modified major adverse limb events (mMALEs) after lower extremity revascularization. METHODS: Patients undergoing PAD revascularization who had hemoglobin A1c (HbA1c) levels available within 6 months were identified in the Veterans Affairs database of 2003 to 2014 (N = 26,799)...
August 22, 2017: Journal of Vascular Surgery
Siew S C Goh
BACKGROUND: Post-sternotomy mediastinitis is associated with significant mortality and morbidity. Despite surgical advances in cardiac surgery and improvements in perioperative care, mediastinitis remains a devastating post-operative complication. This study provides a comprehension review of post-sternotomy mediastinitis in the modern era, and discusses the incidence, risk factors, microbiology, prevention, and management of this complication. METHODS: This review was based on a PubMed/MEDLINE literature search up until 9th March 2017 for publications relevant to mediastinitis post-cardiac surgery...
September 2017: Journal of Cardiac Surgery
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"