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glucose in postoperative period

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https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#1
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28385477/espen-guideline-clinical-nutrition-in-surgery
#2
Arved Weimann, Marco Braga, Franco Carli, Takashi Higashiguchi, Martin Hübner, Stanislaw Klek, Alessandro Laviano, Olle Ljungqvist, Dileep N Lobo, Robert Martindale, Dan L Waitzberg, Stephan C Bischoff, Pierre Singer
Early oral feeding is the preferred mode of nutrition for surgical patients. Avoidance of any nutritional therapy bears the risk of underfeeding during the postoperative course after major surgery. Considering that malnutrition and underfeeding are risk factors for postoperative complications, early enteral feeding is especially relevant for any surgical patient at nutritional risk, especially for those undergoing upper gastrointestinal surgery. The focus of this guideline is to cover nutritional aspects of the Enhanced Recovery After Surgery (ERAS) concept and the special nutritional needs of patients undergoing major surgery, e...
June 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28263048/pancreatic-beta-cell-function-is-preserved-in-the-short-term-in-patients-with-type-2-diabetes-undergoing-non-urgent-surgery
#3
Gema Hernanz-Rodriguez, Pablo Pedrianes-Martin, Pedro de Pablos-Velasco, Aurelio Rodriguez-Perez
AIM: Type 2 diabetes mellitus (T2DM) is a progressive condition influences by many factors. Surgery usually produces hyperglycemia in the postoperative period, which leads to adverse clinical outcomes. Possible consequences of surgery on beta cell reserve have not been explored. The aim of this study was to assess the effect of surgery on the beta cell function of patients with T2DM undergoing non-urgent surgery. MATERIALS AND METHODS: We performed a prospective observational study on the population of patients with T2DM scheduled for surgery in a tertiary level hospital...
March 6, 2017: Minerva Endocrinologica
https://www.readbyqxmd.com/read/28260433/effect-of-graft-weight-to-recipient-body-weight-ratio-on-hemodynamic-and-metabolic-parameters-in-pediatric-liver-transplant-a-retrospective-analysis
#4
Zeynep Ersoy, Serife Kaplan, Aycan Ozdemirkan, Adnan Torgay, Gulnaz Arslan, Arash Pirat, Mehmet Haberal
OBJECTIVES: To analyze how graft-weight-to-bodyweight ratio in pediatric liver transplant affects intraoperative and early postoperative hemodynamic and metabolic parameters. MATERIALS AND METHODS: We reviewed data from 130 children who underwent liver transplant between 2005 and 2015. Recipients were divided into 2 groups: those with a graft weight to body weight ratio > 4% (large for size) and those with a ratio ≤ 4% (normal for size). Data included demographics, preoperative laboratory findings, intraoperative metabolic and hemodynamic parameters, and intensive care follow-up parameters...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28257455/the-impact-of-roux-en-y-gastric-bypass-surgery-on-normal-metabolism-in-a-porcine-model
#5
Andreas Lindqvist, Mikael Ekelund, Eliana Garcia-Vaz, Marcus Ståhlman, Stefan Pierzynowski, Maria F Gomez, Jens F Rehfeld, Leif Groop, Jan Hedenbro, Nils Wierup, Peter Spégel
BACKGROUND: A growing body of literature on Roux-en-Y gastric bypass surgery (RYGB) has generated inconclusive results on the mechanism underlying the beneficial effects on weight loss and glycaemia, partially due to the problems of designing clinical studies with the appropriate controls. Moreover, RYGB is only performed in obese individuals, in whom metabolism is perturbed and not completely understood. METHODS: In an attempt to isolate the effects of RYGB and its effects on normal metabolism, we investigated the effect of RYGB in lean pigs, using sham-operated pair-fed pigs as controls...
2017: PloS One
https://www.readbyqxmd.com/read/28225740/early-pancreatic-dysfunction-after-resection-in-trauma-an-18-year-report-from-a-level-i-trauma-center
#6
Nicole Mansfield, Kenji Inaba, Regan Berg, Elizabeth Beale, Elizabeth Benjamin, Lydia Lam, Kazuhide Matsushima, Demetrios Demetriades
BACKGROUND: Early pancreatic dysfunction after resection in trauma has not been well characterized. The objective of this study was to examine the incidence and clinical impact of new-onset endocrine and exocrine dysfunction after pancreatic resection for trauma. METHODS: All patients sustaining a pancreatic injury from 1996 to 2013 were identified. Patients with preinjury diabetes were excluded. Survivors were divided into three groups according to the extent of anatomic resection-distal, proximal, or total pancreatectomy...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28224472/effects-of-weight-reduction-after-sleeve-gastrectomy-on-metabolic-variables-in-saudi-obese-subjects-in-aseer-province-of-kingdom-of-saudi-arabia
#7
Mohammed A Bawahab, Abdullah S Assiri, Walid Abdel Maksoud, Ayyub Patel, Osama Kadoumi, Gaffar Sarwar Zaman, Riyad Mohammed Khalil Alessih, Syed Saleem Haider
OBJECTIVES: The objectives of this study were to investigate the occurrence of oxidative stress, status of protective antioxidants enzymes, inflammatory biomarkers, and some metabolic health variables in the blood and to compare the results between those of the normal controls and obese patients submitted to sleeve gastrectomy-induced weight loss over a 1-year follow-up period. MATERIALS AND METHODS: A prospective study was conducted in Aseer Central Hospital and Abha Private Hospital in the Kingdom of Saudi Arabia from January 2012 to January 2013 on 50 normal (BMI = 22-25 kg/m(2)) control subjects and 50 obese (BMI = 45-50 kg/m(2)) patients...
February 21, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28222625/shortened-preoperative-fasting-for-prevention-of-complications-associated-with-laparoscopic-cholecystectomy-a-meta-analysis
#8
Duo Xu, Xuejiao Zhu, Yuan Xu, Liqing Zhang
Objective Routine fasting (12 h) is always applied before laparoscopic cholecystectomy, but prolonged preoperative fasting causes thirst, hunger, and irritability as well as dehydration, low blood glucose, insulin resistance and other adverse reactions. We assessed the safety and efficacy of a shortened preoperative fasting period in patients undergoing laparoscopic cholecystectomy. Methods We searched PubMed, Embase and Cochrane Central Register of Controlled Trials up to 20 November 2015 and selected controlled trials with a shortened fasting time before laparoscopic cholecystectomy...
February 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28203408/determinants-of-prolonged-intensive-care-unit-stay-in-patients-after-cardiac-surgery-a-prospective-observational-study
#9
Theodore Kapadohos, Epameinondas Angelopoulos, Ioannis Vasileiadis, Serafeim Nanas, Anastasia Kotanidou, Andreas Karabinis, Katerina Marathias, Christina Routsi
BACKGROUND: Prolonged intensive care unit (ICU) stay of patients after cardiac surgery has a major impact on overall cost and resource utilization. The aim of this study was to identify perioperative factors which prolong stay in ICU. METHODS: All adult patients from a single, specialized cardiac center who were admitted to the ICU after cardiac surgery during a 2-month period were included. Demographic and clinical characteristics, comorbidities, preoperative use of drugs, intraoperative variables, and postoperative course were recorded...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28106608/a-perioperative-systems-design-to-improve-intraoperative-glucose-monitoring-is-associated-with-a-reduction-in-surgical-site-infections-in-a-diabetic-patient-population
#10
Jesse M Ehrenfeld, Jonathan P Wanderer, Maxim Terekhov, Brian S Rothman, Warren S Sandberg
BACKGROUND: Diabetic patients receiving insulin should have periodic intraoperative glucose measurement. The authors conducted a care redesign effort to improve intraoperative glucose monitoring. METHODS: With approval from Vanderbilt University Human Research Protection Program (Nashville, Tennessee), the authors created an automatic system to identify diabetic patients, detect insulin administration, check for recent glucose measurement, and remind clinicians to check intraoperative glucose...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28103372/the-effect-of-epidural-levobupivacaine-and-fentanyl-on-stress-response-and-pain-management-in-patients-undergoing-percutaneous-nephrolithotomy
#11
A Ahiskalioglu, O Ahiskalioglu, A Dostbil, C Abdullah, A Megnet, M Celik, I Ilker, K Husnu
Objective: The perioperative stress response of patients who were scheduled to have percutaneous nephrolithotomy under epidural anaesthesia with opioids and local anaesthetics has not been investigated in detail yet. Our hypothesis is that the stress response following percutaneous nephrolithotomy can be lessened by epidural analgesia. Methods: A total of 48 patients, between 18-65 years of age and ASA I-II, for whom elective percutaneous nephrolithotomy was planned, were randomly divided into two groups namely: Group GA (n = 24): general anaesthesia by sevoflurane and fentanyl and postoperative intravenous PCA; Group GE (n = 24): epidural anaesthesia and general anaesthesia together with postoperative epidural analgesia (0...
March 14, 2016: West Indian Medical Journal
https://www.readbyqxmd.com/read/28073036/does-preoperative-oral-carbohydrate-treatment-reduce-the-postoperative-surgical-stress-response-in-lumbar-disc-surgery
#12
RANDOMIZED CONTROLLED TRIAL
Ozlem Korkmaz Dilmen, Ercument Yentur, Yusuf Tunali, Huriye Balci, Mois Bahar
OBJECTIVES: Surgical trauma produces metabolic and hormonal responses, which are characterized by insulin resistance. Due to extension of the preoperative fasting period, which increases the magnitude of postoperative insulin resistance, preoperative oral carbohydrates (POC) have been developed. PATIENTS AND METHODS: This prospective, randomized, controlled study was performed on 43 ASA I-II patients undergoing elective microsurgical lumbar discectomy. The intervention group received oral carbohydrate solution 800mL the night before and 400mL 2h prior to operation...
February 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28048971/insulin-resistance-plays-a-potential-role-in-postoperative-cognitive-dysfunction-in-patients-following-cardiac-valve-surgery
#13
Ni Tang, Rongrong Jiang, Xiaobin Wang, Jian Wen, Li Liu, Jiali Wu, Chunxiang Zhang
Severe insulin resistance(IR) promotes the development of Alzheimer disease. IR and postoperative cognitive dysfunction (POCD) are a common complication during the cardiac perioperative period. The authors hypothesized that IR of individuals with cardiac valve surgery would have increased the risk of POCD. The purpose of the study was to analyze the association of IR and POCD after cardiac valve surgery. Total 131 patients who underwent valve replacement via cardiopulmonary bypass(CPB) were included. Cognitive function was assessed by a series of neuropsychological measurements at 1 day before and 7 days after the surgery...
December 31, 2016: Brain Research
https://www.readbyqxmd.com/read/27974387/decrease-of-serum-igf-i-following-transsphenoidal-pituitary-surgery-for-acromegaly
#14
Min Yu, David E Bruns, John A Jane, Ralf M Nass, Edward H Oldfield, Mary Lee Vance, Michael O Thorner
BACKGROUND: In the immediate postoperative period following resection of growth hormone (GH)-secreting pituitary tumors, serum concentrations of GH have limited ability to predict remission of acromegaly. Since many actions of GH actions are mediated by insulin-like growth factor-1 (IGF-I), we aimed to determine the rates of fall of IGF-I during 72 h after surgical resection of pituitary tumors. METHODS: We studied patients who were undergoing pituitary surgery for acromegaly...
February 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/27876524/lower-extremity-weakness-is-associated-with-elevated-blood-and-cerebrospinal-fluid-glucose-levels-following-multibranched-endovascular-aortic-aneurysm-repair
#15
Jade S Hiramoto, Charlene Fernandez, Warren Gasper, Shant Vartanian, Linda Reilly, Timothy Chuter
OBJECTIVE: Hyperglycemia is associated with worsened clinical outcomes after central nervous system injury. The purpose of this study was to examine the association between lower extremity weakness (LEW) and the glucose levels of blood and cerebrospinal fluid (CSF) in patients undergoing multibranched endovascular aneurysm repair (MBEVAR) of thoracoabdominal and pararenal aortic aneurysms. METHODS: Blood and CSF samples were collected preoperatively, immediately after aneurysm repair, and on postoperative day 1 in 21 patients undergoing MBEVAR...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27819771/glycemic-outcomes-3-years-after-implementation-of-a-peri-operative-glycemic-control-algorithm-in-an-academic-institution
#16
Lindsay M Arnold, Mufaddal Mahesri, Marie E McDonnell, Sara M Alexanian
OBJECTIVE: While hyperglycemia in the postoperative setting has been linked to an increase in surgical complications, limited data are available to inform the management of patients with diabetes in the operating room and the immediate peri-operative period. We describe the results of a peri-operative glycemic control program that standardized intravenous insulin with a target glucose (BG) range of 120 to 180 mg/dL for patients with diabetes presenting with a BG level >180 mg/dL and included transition to subcutaneous insulin...
February 2017: Endocrine Practice
https://www.readbyqxmd.com/read/27801414/-incretin-secretion-and-glucose-metabolism-in-morbidly-obese-patients-in-the-early-and-late-periods-after-biliopancreatic-diversion
#17
I I Dedov, G A Mel'nichenko, E A Troshina, E V Ershova, N V Mazurina, N A Ogneva, Yu I Yashkov, A V Il'in
AIM: To estimate the parameters of glucose metabolism and to assess the secretion of incretins in patients after biliopancreatic diversion (BPD) for morbid obesity (MO) in the early and late postoperative periods. SUBJECTS AND METHODS: The prospective part of the investigation included 22 patients with a body mass index of 35.8 to 68.4 kg/m2 and type 2 diabetes mellitus (T2DM). All the patients were examined before, 3 weeks and 3 months after BPD. The retrospective part covered 23 patients who were examined after BPD for MO; the postoperative period was 4...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27795903/effects-of-pressure-controlled-and-volume-controlled-ventilation-on-respiratory-mechanics-and-systemic-stress-response-during-prone-position
#18
Oznur Sen, Mefkur Bakan, Tarik Umutoglu, Nurdan Aydın, Mehmet Toptas, Ibrahim Akkoc
BACKGROUND: Prone position during general anesthesia for special surgical operations may be related with increased airway pressure, decreased pulmonary and thoracic compliance that may be explained by restriction of chest expansion and compression of abdomen. The optimum ventilation mode for anesthetized patients on prone position was not described and studies comparing volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) during prone position are limited. We hypothesized that PCV instead of VCV during prone position could achieve lower airway pressures and reduce the systemic stress response...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27766549/daily-life-reflections-of-acromegaly-guidelines
#19
T Apaydin, H M Ozkaya, F E Keskin, O A Haliloglu, K Karababa, S Erdem, P Kadioglu
PURPOSE: To determine the differences in acromegaly diagnosis, treatment, and follow-up among Turkish endocrinologists, and to investigate how the published guidelines are applied in clinical practice. METHODS: The questionnaire was formatted as an electronic survey, conducted between November and December 2015, and sent weekly for 6 weeks via e-mail to 528 endocrinologists in Turkey. RESULTS: The questionnaire was answered by 37.4 % of endocrinologists...
October 20, 2016: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/27749341/association-between-perioperative-hyperglycemia-or-glucose-variability-and-postoperative-acute-kidney-injury-after-liver-transplantation-a-retrospective-observational-study
#20
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...
January 2017: Anesthesia and Analgesia
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