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Perioperative hyperglycemia

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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
#1
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
#2
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/29598945/hyperglycemia-and-risk-of-adverse-outcomes-following-microvascular-reconstruction-of-oncologic-head-and-neck-defects
#3
Anaeze C Offodile, Hsuan-Yu Chou, Jennifer An-Jou Lin, Charles Yuen Yung Loh, Kai-Ping Chang, Mario A Aycart, Huang-Kai Kao
INTRODUCTION: Our aim is to examine the correlation between perioperative hyperglycemia and post-operative outcomes following microvascular reconstruction of head and neck defects. PATIENTS AND METHODS: Retrospective review of a prospectively collected database of 350 consecutive patients who underwent microvascular reconstruction of malignant head and neck defects over a 2 year period. The relationship between perioperative hyperglycemia (≥ 180 mg/dL) and the incidence of the following complications was evaluated: flap loss, flap-related complications and surgical site infections (SSI)...
April 2018: Oral Oncology
https://www.readbyqxmd.com/read/29589415/perioperative-hyperglycaemia-and-neurocognitive-outcome-after-surgery-a-systematic-review
#4
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
#5
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/29512047/perioperative-hyperglycemia-an-unmet-need-within-a-surgical-site-infection-bundle
#6
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 6, 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29498137/impact-of-perioperative-hyperglycemia-in-patients-undergoing-microvascular-reconstruction
#7
Craig A Bollig, Claire S Spradling, Laura M Dooley, Tabitha L Galloway, Jeffrey B Jorgensen
BACKGROUND: The effects of perioperative hyperglycemia on complications and outcomes in microvascular reconstruction have not been reported in the literature. METHODS: A retrospective cohort of 203 patients undergoing microvascular reconstruction was generated. Perioperative glucose levels and clinical factors were tested for associations with complications using simple and multivariate analyses. RESULTS: Hyperglycemia (blood glucose ≥ 180 mg/dL) occurred in 91 patients (44...
March 1, 2018: Head & Neck
https://www.readbyqxmd.com/read/29492325/management-of-concomitant-metabolic-encephalopathy-and-meningioma-with-vasogenic-edema-and-impending-herniation
#8
Ramsis F Ghaly, Armen Haroutunian, Kenneth D Candido, Nebojsa Nick Knezevic
Background: Altered mental status describes impaired mental functioning ranging from confusion to coma and indicates an illness, either metabolic or structural in nature. Metabolic causes include hypothyroidism, hyperuremia, hypo/hyperglycemia, hypo/hypernatremia, and encephalopathy. The structural causes include tumors, brain hemorrhage, infection, and stroke. To our knowledge, this is the first case in which a patient presented with altered mental status from both metabolic (myxedema coma) and structural diseases (frontal meningioma) with vasogenic edema and midline shift...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29407052/perioperative-management-of-hyperglycemia-and-diabetes-in-cardiac-surgery-patients
#9
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/29391105/hyperglycemia-is-associated-with-surgical-site-infections-among-general-and-vascular-surgery-patients
#10
Amy Showen, Tara A Russell, Stephanie Young, Sachin Gupta, Melinda M Gibbons
Surgical site infection (SSI) is a common cause of morbidity in general and vascular surgery patients. There is inconsistent evidence on the association of glycemic status with SSI, and its utility in predicting and mitigating SSI. General and vascular surgery patients at a public teaching hospital had the following markers of glycemic status prospectively collected: preoperative hemoglobin A1c (HbA1c) and capillary blood glucose (cBG, within six months before surgery), perioperative cBG (within 24 hours before surgery), and postoperative cBG (peak value up to 48 hours after surgery)...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29390415/is-hemoglobin-a1c-and-perioperative-hyperglycemia-predictive-of-periprosthetic-joint-infection-following-total-joint-arthroplasty-a-systematic-review-and-meta-analysis
#11
Liqing Yang, Yuefeng Sun, Ge Li, Jiulong Liu
OBJECTIVE: This meta-analysis aims to determine whether hemoglobin A1c (HbA1c) and perioperative hyperglycemia are associated with the increased risk of periprosthetic joint infection following total knee and hip arthroplasty. METHODS: A systematic search is performed in Medline (1966-October 2017), PubMed (1966-October 2017), Embase (1980-October 2017), ScienceDirect (1985-October 2017), and the Cochrane Library. Only high-quality studies are selected. A meta-analysis is performed using Stata 11...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29356912/current-status-and-issues-of-the-artificial-pancreas-abridged-english-translation-of-a-special-issue-in-japanese
#12
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
#13
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/29273446/stress-hyperglycemia-in-general-surgery-why-should-we-care
#14
Georgia Davis, Maya Fayfman, David Reyes-Umpierrez, Shahzeena Hafeez, Francisco J Pasquel, Priyathama Vellanki, J Sonya Haw, Limin Peng, Sol Jacobs, Guillermo E Umpierrez
AIMS: To determine the frequency of increasing levels of stress hyperglycemia and its associated complications in surgery patients without a history of diabetes. METHODS: We reviewed hospital outcomes in 1971 general surgery patients with documented preoperative normoglycemia [blood glucose (BG) <140mg/dL] who developed stress hyperglycemia (BG >140mg/dL or >180mg/dL) within 48h after surgery between 1/1/2010 and 10/31/2015. RESULTS: A total of 415 patients (21%) had ≥1 episode of BG between 140 and 180mg/dL and 206 patients (10...
March 2018: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/29260243/-perioperative-handling-of-antidiabetic-drugs
#15
REVIEW
J Wagner, V Luber, J F Lock, U A Dietz, S Lichthardt, N Matthes, K Krajinovic, C-T Germer, S Knop, A Wiegering
Diabetes mellitus is the most frequent metabolic disorder in the western world with a prevalence of 3% in adults under 65 years of age and 14.3% in adults over 65 years of age. Due to the increasing age of our population, the number of patients taking oral antidiabetic drugs has increased. Thus, operating physicians must make a risk-adapted decision whether the medication can be continued perioperatively or if certain drugs must be paused, and if so, with what risks. Operative interventions can lead to a number of metabolic shifts, which change the normal glucose metabolism...
February 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29223421/a-prospective-multi-institutional-cohort-study-of-mediastinal-infections-after-cardiac-operations
#16
Louis P Perrault, Katherine A Kirkwood, Helena L Chang, John C Mullen, Brian C Gulack, Michael Argenziano, Annetine C Gelijns, Ravi K Ghanta, Bryan A Whitson, Deborah L Williams, Nancy M Sledz-Joyce, Brian Lima, Giampaolo Greco, Nishit Fumakia, Eric A Rose, John D Puskas, Eugene H Blackstone, Richard D Weisel, Michael E Bowdish
BACKGROUND: Mediastinal infections are a potentially devastating complication of cardiac operations. This study analyzed the frequency, risk factors, and perioperative outcomes of mediastinal infections after cardiac operations. METHODS: In 2010, 5,158 patients enrolled in a prospective study evaluating infections after cardiac operations and their effect on readmissions and mortality for up to 65 days after the procedure. Clinical and demographic characteristics, operative variables, management practices, and outcomes were compared for patients with and without mediastinal infections, defined as deep sternal wound infection, myocarditis, pericarditis, or mediastinitis...
February 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29204776/implications-of-hyperthermic-intraperitoneal-chemotherapy-perfusion-related-hyperglycemia
#17
Camille L Stewart, Ana Gleisner, Alison Halpern, Irada Ibrahim-Zada, Rodrigo Asturias Luna, Nathan Pearlman, Csaba Gajdos, Barish Edil, Martin McCarter
BACKGROUND: Hyperthermic intraperitoneal chemotherapy (HIPEC) administration can be associated with hyperglycemia during perfusion. Little is known about this effect, and no previous studies have examined patient characteristics associated with perfusion-related hyperglycemia. METHODS: We retrospectively identified consecutive patients at a single institution treated with HIPEC from 8/2003 to 10/2016 who had intraoperative blood glucose measured. Hypertonic 1.5% dextrose-containing peritoneal dialysate was used as carrier solution in all patients...
March 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29162977/perioperative-management-of-patients-with-diabetes
#18
REVIEW
Vivien Leung, Kristal Ragbir-Toolsie
Hyperglycemia has long been recognized to have detrimental effects on postoperative outcomes in patients undergoing surgery. The manifestations of uncontrolled diabetes are manifold and can include risk of hyperglycemic crises, postoperative infection, poor wound healing, and increased mortality. There is substantial literature supporting the role of diligent glucose control in the prevention of adverse surgical outcomes, but considerable debate remains as to the optimal glucose targets. Hence, most organizations advocate the avoidance of hypoglycemia while striving for adequate glucose control in the perioperative period...
2017: Health Services Insights
https://www.readbyqxmd.com/read/29128103/the-benefits-of-a-low-dose-complex-carbohydrate-citrulline-electrolyte-solution-for-preoperative-carbohydrate-loading-focus-on-glycemic-variability
#19
Barrett A Kielhorn, Anthony J Senagore, Theodor Asgeirsson
BACKGROUND: Perioperative insulin resistance is associated with significant hyperglycemia-related morbidity in patients undergoing major surgery. We sought to assess the effect of preoperative loading with a low-dose maltodextrin/citrulline solution compared to a commercially available sports drink on glycemic levels in an established colorectal enhanced recovery program. METHODS: Retrospective analysis was undertaken of elective non-diabetic colectomies and enterectomies from January 2016-March 2017...
November 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29067250/basal-insulin-therapy-is-associated-with-beneficial-effects-on-postoperative-infective-complications-independently-from-circulating-glucose-levels-in-patients-admitted-for-cardiac-surgery
#20
P M Piatti, M Cioni, A Magistro, V Villa, V G Crippa, E Galluccio, B Fontana, S Spadoni, E Bosi, L D Monti, O Alfieri
BACKGROUND: Although hyperglycemia is a strong predictor of postoperative infective complications (PIC), little is known about the effect of basal insulin therapy (BIT) per se on PIC. AIM: To evaluate if there is an association between BIT, independent of glucose levels, and a possible improvement of PIC during the perioperative cardiosurgery period (PCP). METHODS: In 812 patients admitted for cardiac intervention and treated with a continuous intravenous insulin infusion (CIII) for hyperglycemic levels (>130 mg/dl), a retrospective analysis was performed during the PCP (January 2009-December 2011)...
March 2017: Journal of Clinical & Translational Endocrinology
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