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Perioperative hyperglycemia

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
Ranjana Khetarpal, Veena Chatrath, Jagjit Kaur, Anju Bala, Harjeet Singh
BACKGROUND: Intravenous (IV) fluids are an integral part of perioperative management. Intraoperative hyperglycemia is associated with poor clinical outcomes in patients undergoing major surgeries even in nondiabetics. AIM: This study was conducted to observe the effect of different maintenance fluid regimens on intraoperative blood glucose levels in nondiabetic patients undergoing major surgeries under general anesthesia. SETTINGS AND DESIGN: Randomized double-blind study...
September 2016: Anesthesia, Essays and Researches
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
Kotoe Kamata, Nobutada Morioka, Takashi Maruyama, Noriaki Komayama, Masayuki Nitta, Yoshihiro Muragaki, Takakazu Kawamata, Makoto Ozaki
PURPOSE: Intraoperative vomiting leads to serious respiratory complications that could influence the surgical decision-making process for awake craniotomy. However, the use of antiemetics is still limited in Japan. The aim of this study was to investigate the effect of prophylactically administered single low-dose dexamethasone on the incidence of vomiting during awake craniotomy. The frequency of hyperglycemia was also examined. METHODS: We conducted a retrospective case review of awake craniotomy for glioma resection between 2012 and 2015...
August 29, 2016: Journal of Anesthesia
Katherine Hagan, Shreyas Bhavsar, Radha Arunkumar, Roxana Grasu, Anh Dang, Richard Carlson, Charles Cowles, Benjamin Arnold, Yuri Potylchansky, Thomas F Rahlfs, Ian Lipski, Caroline Walsh, Federico Jimenez, Anh T Nguyen, Lei Feng, Juan P Cata
BACKGROUND: Several studies have examined the association between hyperglycemia in the first 10 to 12 weeks following surgery and postoperative survival in glioblastoma multiforme (GBM) patients. We hypothesize that episodes of hyperglycemia before, during and/or following surgery for primary GBM are independent predictors of disease progression and mortality. MATERIALS AND METHODS: A total of 162 adult patients were included in the analysis. All patients received adjuvant temozolamide...
July 19, 2016: Journal of Neurosurgical Anesthesiology
Jiaqiang Wang, Hui Jiang, Jing Wang, Yanjun Zhao, Yun Zhu, Minmin Zhu
Perioperative hyperglycemia is a common clinical metabolic disorder. Hyperglycemia could induce endothelial apoptosis, dysfunction and inflammation, resulting in endothelial injury. Propofol is a widely used anesthetic drug in clinical settings. Our previous studies indicated that propofol attenuated high glucose-induced endothelial apoptosis, dysfunction and inflammation via inhibiting reactive oxygen species (ROS) accumulation. However, the mechanisms by which propofol reduces high glucose-induced endothelial ROS accumulation is still obscure...
July 1, 2016: Fundamental & Clinical Pharmacology
Claudio Fiorillo, Fausto Rosa, Giuseppe Quero, Roberta Menghi, Giovanni Battista Doglietto, Sergio Alfieri
BACKGROUND: Hyperglycemia (HG) is widely known to be associated with increased postoperative complications after colorectal surgery. Very few data on the effects of HG on patients after gastric surgery for cancer are reported in literature. The aim of this study was to evaluate the effects of postoperative HG in non-diabetic patients undergoing gastrectomy for cancer. METHODS: One hundred and ninety-three consecutive gastrectomies for cancer performed between January 2010 and December 2015 were considered...
June 23, 2016: Gastric Cancer
Riyoko Shigeno, Ichiro Horie, Takao Ando, Norio Abiru, Atsushi Kawakami
A low-carbohydrate diet is effective to improve hyperglycemia via insulin-independent actions. We report here that a low-carbohydrate diet combined with an SGLT2 inhibitor was effective and safe to treat refractory hyperglycemia in the perioperative period in a type 2 diabetes patient complicated with a high titer of insulin antibodies.
June 2016: Diabetes Research and Clinical Practice
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
Michelle Louie, Tarek Toubia, Lauren D Schiff
PURPOSE OF REVIEW: The purpose is to review the key anatomical and physiological changes in obese patients and their effects on preoperative, intraoperative, and postoperative care and to highlight the best practices to safely extend minimally invasive approaches to obese patients and provide optimal surgical outcomes in this high-risk population. RECENT FINDINGS: Minimally invasive surgery is safe, feasible, and cost-effective for obese patients. Obesity is associated with anatomical and physiological changes in almost all organ systems, which necessitates a multimodal approach and an experienced, multidisciplinary team...
August 2016: Current Opinion in Obstetrics & Gynecology
Manoj Kumar, Manoj Tripathi, Deepak Malviya, P S Malviya, Virendra Kumar, Amit Tyagi
BACKGROUND: Head injury presents a major worldwide social, economic, and health problem. Hyperglycemia is a significant indicator of the severity of injury and predictor of outcome, which can easily be prevented. There has been a long-standing controversy regarding the use of inhalational or intravenous (i.v.) anesthetic agents for surgery of head injury cases and impact of these agents on blood sugar level. AIMS AND OBJECTIVES: The aim of this study is to find out anesthetic drugs and technique having minimal or no effect on the blood sugar, and Glasgow Coma Scale (GCS) of patients with a head injury by comparing two types of anesthetic techniques in surgery of head injury patients...
May 2016: Anesthesia, Essays and Researches
Ullhas Sudhakarrao Misal, Suchita Annasaheb Joshi, Mudassir Mohd Shaikh
Delayed awakening from anesthesia remains one of the biggest challenges that involve an anesthesiologist. With the general use of fast-acting anesthetic agents, patients usually awaken quickly in the postoperative period. The time to emerge from anesthesia is affected by patient factors, anesthetic factors, duration of surgery, and painful stimulation. The principal factors responsible for delayed awakening following anesthesia are anesthetic agents and medications used in the perioperative period. Nonpharmacological causes may have a serious sequel, hence recognizing these organic conditions is important...
May 2016: Anesthesia, Essays and Researches
Muhammad Bilal, Abdul Haseeb, Mohammad Hassaan Khan, Akash Khetpal, Muhammad Saad, Mohammad Hussham Arshad, Mudassir Iqbal Dar, Najya Hasan, Rafia Rafiq, Maryam Sherwani, Haider Abbas, Ayesha Sultan, Maha Inam
INTRODUCTION: Perioperative hyperglycemia has been shown to be related to higher levels of morbidity and mortality in patients on cardiopulmonary bypass (CPB) undergoing coronary artery bypass grafting (CABG), both diabetic and non-diabetic. Blood electrolytes, like sodium, potassium, calcium, and chloride play a very important role in the normal functioning of the body and can lead to a variety of clinical disorders if they become deficient. A minimal number of studies have been conducted on the simultaneous perioperative changes in both blood glucose and electrolyte levels during CPB in Pakistan...
2016: Global Journal of Health Science
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
Louis S Stryker
An estimated 29.1 million Americans are currently diagnosed with diabetes, and this number is expected to increase to 48.3 million Americans by 2050. Correspondingly, the present burden of diabetes among patients undergoing total joint arthroplasty is significant and rising. Diabetes as a chronic condition is a well-established risk factor for complication after total joint arthroplasty. A growing body of evidence also indicates that hyperglycemia in the perioperative period, and not the diagnosis of diabetes alone, is similarly associated with increased complication risk...
August 2016: Journal of Arthroplasty
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
Xianzhang Zeng, Honglei Wang, Xichun Xing, Qi Wang, Wenzhi Li
BACKGROUND: Transient global cerebral ischemia/reperfusion (I/R) is a major perioperative complication, and diabetes increases the response of oxidative stress and inflammation induced by I/R. The objective of this study was to determine the protective effect of dexmedetomidine against transient global cerebral ischemia/reperfusion induced oxidative stress and inflammation in diabetic rats. METHODS: Sixty-four rats were assigned into four experimental groups: normoglycemia, normoglycemia + dexmedetomidine, hyperglycemia, and hyperglycemia + dexmedetomidine and all subsequent neurological examinations were evaluated by a blinded observer...
2016: PloS One
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
Elizabeth W Duggan, Matthew A Klopman, Arnold J Berry, Guillermo Umpierrez
Hyperglycemia is a frequent manifestation of critical and surgical illness, resulting from the acute metabolic and hormonal changes associated with the response to injury and stress (Umpierrez and Kitabchi, Curr Opin Endocrinol. 11:75-81, 2004; McCowen et al., Crit Care Clin. 17(1):107-24, 2001). The exact prevalence of hospital hyperglycemia is not known, but observational studies have reported a prevalence of hyperglycemia ranging from 32 to 60 % in community hospitals (Umpierrez et al., J Clin Endocrinol Metab...
March 2016: Current Diabetes Reports
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