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Perioperative hyperglycemia

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https://www.readbyqxmd.com/read/28571661/-evaluation-and-perioperative-management-of-patients-with-diabetes-mellitus-a-challenge-for-the-anesthesiologist
#1
REVIEW
João Paulo Jordão Pontes, Florentino Fernandes Mendes, Mateus Meira Vasconcelos, Nubia Rodrigues Batista
Diabetes mellitus (DM) is characterized by alteration in carbohydrate metabolism, leading to hyperglycemia and increased perioperative morbidity and mortality. It evolves with diverse and progressive physiological changes, and the anesthetic management requires attention regarding this pathology interference in multiple organ systems and their respective complications. Patient's history, physical examination, and complementary exams are important in the preoperative management, particularly glycosylated hemoglobin (HbA1c), which has a strong predictive value for complications associated with diabetes...
May 29, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28555510/perioperative-blood-glucose-concentrations-in-kittens-following-overnight-fasting-and-gonadectomy
#2
Danielle N Semick, Stephanie L Shaver, Heather N Cornell, Nancy C Bradley, Rachael E Kreisler
Objectives The objective of this study was to determine if hypoglycemia is an effect of overnight fasting and gonadectomy in kittens, as well as to determine predictors of baseline and postoperative blood glucose. Methods This was a prospective observational study. Seventy-five kittens between the age of 8 and 16 weeks undergoing routine castration or ovariohysterectomy at an animal shelter were included. Two blood glucose measurements were analyzed per kitten after an overnight fast: a baseline reading prior to preoperative examination, and a reading immediately postoperatively...
May 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28502888/prospective-study-of-postoperative-glycemic-control-with-a-standardized-insulin-infusion-protocol-after-infrainguinal-bypass-and-open-abdominal-aortic-aneurysm-repair
#3
Andrea M Steely, Lisa Smith, Peter W Callas, Muriel H Nathan, Julie E Lahiri, Andrew C Stanley, Georg Steinthorsson, Daniel J Bertges
INTRODUCTION: The aim of this study was to examine the effect of moderate postoperative glycemic control in diabetic and non-diabetic patients undergoing infrainguinal bypass (INFRA) or open abdominal aortic aneurysm (OAAA) repair. METHODS: In a single center prospective study, we investigated postoperative glycemic control using a standardized insulin infusion protocol after elective INFRA (n=53, 62%) and OAAA (n=33, 38%) between January 2013 and March 2015. The primary endpoint was optimal glycemic control, defined as having ≥85% of blood glucose values within the 80-150mg/dL target range...
May 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#4
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/28343827/diabetes-mellitus-and-hyperglycemia-and-the-risk-of-aseptic-loosening-in-total-joint-arthroplasty
#5
Hilal Maradit Kremers, Cathy D Schleck, Eric A Lewallen, Dirk R Larson, Andre J Van Wijnen, David G Lewallen
BACKGROUND: It is unknown to what extent diabetes mellitus modifies the long-term risk of aseptic loosening in total hip arthroplasty (THA) and total knee arthroplasty (TKA). We examined the association between diabetes mellitus, perioperative hyperglycemia, and the likelihood of revisions for aseptic loosening. METHODS: We studied 16,085 primary THA and TKA procedures performed at a large tertiary care hospital between 2002 and 2009. All blood glucose values around the time of surgery (within 1 week) were retrieved...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28256812/severe-perioperative-hyperglycemia-attenuates-postoperative-monocytic-function-basophil-count-and-t-cell-activation
#6
Gunnar Lachmann, Clarissa von Haefen, Tobias Wollersheim, Claudia Spies
BACKGROUND: Hyperglycemia in hospitalized patients is associated with increased morbidity and mortality. Postoperative infections are particularly common in the setting of preoperative hyperglycemia; however, the relationship between perioperative glucose levels and the innate immune system remains unclear. METHODS: Immune cells, monocytic respectively T cell function and T cell subspecies of 32 patients after esophageal or pancreatic resection were analyzed preoperatively and on the first day after surgery (pod1)...
March 3, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28197025/current-perioperative-management-of-pheochromocytomas
#7
REVIEW
Rashmi Ramachandran, Vimi Rewari
Neuroendocrine tumors which have the potential to secrete catecholamines are either associated with sympathetic adrenal (pheochromocytoma) or nonadrenal (paraganglioma) tissue. Surgical removal of these tumors is always indicated to cure and prevent cardiovascular and other organ system complications associated with catecholamine excess. Some of these tumors have malignant potential as well. The diagnosis, localization and anatomical delineation of these tumors involve measurement of catecholamines and their metabolic end products in plasma and urine, (123)I-metaiodobenzylguanidine scintigraphy, computed tomography, and/or magnetic resonance imaging...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28188886/propofol-inhibits-high-glucose-induced-pp2a-expression-in-human-umbilical-vein-endothelial-cells
#8
Qichao Wu, Yanjun Zhao, Wenming Duan, Yi Liu, Xiangyuan Chen, 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, via inhibiting high glucose-induced phosphatase A2 (PP2A) expression, attenuated high glucose-induced reactive oxygen species (ROS) accumulation, thus improving endothelial apoptosis, dysfunction and inflammation. However, the mechanisms by which propofol attenuated high glucose-induced PP2A expression is still obscure...
February 8, 2017: Vascular Pharmacology
https://www.readbyqxmd.com/read/28183563/effect-of-basal-insulin-dosage-on-blood-glucose-concentration-in-ambulatory-surgery-patients-with-type-2-diabetes
#9
Linda J Demma, Karen T Carlson, Elizabeth W Duggan, John Gordon Morrow, Guillermo Umpierrez
STUDY OBJECTIVE: Among patients with type 2 diabetes treated with insulin, perioperative hyperglycemia and hypoglycemia may cause undesirable symptoms, surgery delay or cancellation, or unexpected hospitalization. Our objective was to compare preoperative glargine dosing regimens on perioperative glycemic control in patients undergoing ambulatory surgery. DESIGN: Observational study. SETTING: Pre- and postoperative holding areas. PATIENTS: One hundred fifty patients with type 2 diabetes using a once daily, evening insulin glargine regimen undergoing ambulatory surgery were included...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28121636/perioperative-hyperglycemia-management-an-update
#10
Elizabeth W Duggan, Karen Carlson, Guillermo E Umpierrez
No abstract text is available yet for this article.
March 2017: Anesthesiology
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
#11
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/27922839/safety-of-perioperative-glucocorticoids-in-elective-noncardiac-surgery-a-systematic-review-and-meta-analysis
#12
REVIEW
Andrew J Toner, Vyhunthan Ganeshanathan, Matthew T Chan, Kwok M Ho, Tomas B Corcoran
BACKGROUND: Glucocorticoids are increasingly used perioperatively, principally to prevent nausea and vomiting. Safety concerns focus on the potential for hyperglycemia and increased infection. The authors hypothesized that glucocorticoids predispose to such adverse outcomes in a dose-dependent fashion after elective noncardiac surgery. METHODS: The authors conducted a systematic literature search of the major medical databases from their inception to April 2016...
February 2017: Anesthesiology
https://www.readbyqxmd.com/read/27896927/a-retrospective-review-of-anesthesia-and-perioperative-care-in-children-with-medium-chain-acyl-coa-dehydrogenase-deficiency
#13
Claire Allen, Russell Perkins, Bernd Schwahn
BACKGROUND: Medium-chain acyl-CoA dehydrogenase deficiency is the most common genetically determined disorder of mitochondrial fatty acid oxidation. Decompensation can result in hypoglycemia, seizures, coma, and death but may be prevented by ensuring glycogen stores do not become depleted. Perioperative care is of interest as surgery, fasting, and infection may all trigger decompensation and the safety of anesthetic agents has been questioned. Current guidelines from the British Inherited Metabolic Disease Group advise on administering fluid containing 10% glucose during the perioperative period...
January 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27847739/epinephrine-induced-lactic-acidosis-in-orthognathic-surgery-a-report-of-two-cases
#14
Hee-Won Son, Se-Hun Park, Hyun-Oh Cho, Yong-Joon Shin, Jang-Ho Son
Submucosal infiltration and the topical application of epinephrine as a vasoconstrictor produce excellent hemostasis during surgery. The hemodynamic effects of epinephrine have been documented in numerous studies. However, its metabolic effects (especially during surgery) have been seldom recognized clinically. We report two cases of significant metabolic effects (including lactic acidosis and hyperglycemia) as well as hemodynamic effects in healthy patients undergoing orthognathic surgery with general anesthesia...
October 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/27819771/glycemic-outcomes-3-years-after-implementation-of-a-peri-operative-glycemic-control-algorithm-in-an-academic-institution
#15
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/27811445/a-retrospective-analysis-of-blood-gases-with-two-different-insulin-infusion-protocols-in-patients-undergoing-cardiovascular-surgery
#16
S M Kuskonmaz, Ö Kurtipek, M E Aydın, M E Erbatur, M Alkan, Y Ünal, M Arslan
AIM: Intraoperative blood glucose concentration is known to be an independent risk factor for morbidity and mortality in patients undergoing cardiovascular surgery. Arterial blood gas analysis is an important investigation to monitor the acid-base balance and gas exchange in these patients. Hyperglycemia leads to a series of metabolic changes which affect acid-base balance and serum electrolytes. In this study, we aimed to look into the effect of glycemic control on arterial blood gas parameters, serum electrolytes, and hemoglobin (Hb)...
November 2016: Nigerian Journal of Clinical Practice
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
#17
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
https://www.readbyqxmd.com/read/27746527/impact-of-different-intravenous-fluids-on-blood-glucose-levels-in-nondiabetic-patients-undergoing-elective-major-noncardiac-surgeries
#18
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
https://www.readbyqxmd.com/read/27678503/perioperative-hyperglycemia-and-postoperative-outcomes-in-patients-undergoing-resection-of-colorectal-liver-metastases
#19
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
https://www.readbyqxmd.com/read/27572549/the-effect-of-single-low-dose-dexamethasone-on-vomiting-during-awake-craniotomy
#20
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...
December 2016: Journal of Anesthesia
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