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Perioperative hyperglycemia

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https://www.readbyqxmd.com/read/29204776/implications-of-hyperthermic-intraperitoneal-chemotherapy-perfusion-related-hyperglycemia
#1
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...
December 4, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29162977/perioperative-management-of-patients-with-diabetes
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/29040204/perioperative-glycemic-control-and-postoperative-complications-in-patients-undergoing-emergency-general-surgery-what-is-the-role-of-hba1c
#5
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...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28985843/total-parenteral-nutrition-in-patients-following-pancreaticoduodenectomy-lessons-from-1184-patients
#6
Cullen E Worsh, Talar Tatarian, Awinder Singh, Michael J Pucci, Jordan M Winter, Charles J Yeo, Harish Lavu
BACKGROUND: Total parenteral nutrition (TPN) has historically been used conservatively in the management of patients after pancreaticoduodenectomy (PD). Herein, we evaluate the indications for and outcomes associated with TPN use in a high-volume pancreatic surgery center. MATERIALS AND METHODS: We retrospectively queried our institution's pancreatic surgery database for patients who received TPN after PD from 2006 through 2015. RESULTS: Of 1184 patients who underwent PD, 232 (19...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28975077/the-effects-of-dexmedetomidine-administration-on-postoperative-blood-glucose-levels-in-diabetes-mellitus-patients-undergoing-spinal-anesthesia-a-pilot-study
#7
So Hui Yun, Yun Suk Choi
BACKGROUND: Dexmedetomidine (DEX) is an α2-adrenergic receptor agonist with sedative and sympatholytic effects. It inhibits the stress response and insulin secretion. Therefore, postoperative changes to blood glucose levels were investigated when DEX was intraoperatively infused for sedation purposes in diabetic patients under spinal anesthesia. METHODS: Twenty diabetic patients were randomly allocated to two groups (n = 10). Group A patients were infused with DEX at a dose of 0...
December 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28953045/perioperative-acute-kidney-injury-an-under-recognized-problem
#8
Melanie Meersch, Christoph Schmidt, Alexander Zarbock
The incidence of perioperative acute kidney injury (AKI) is more common than previously recognized, especially in high-risk patients undergoing higher risk procedures. The growing number of patients who develop perioperative AKI is related, in part, to the aging population and increase in the number of individuals with chronic comorbidities, particularly those with premorbid chronic kidney disease. Despite the acceptance of standardization in the definition of AKI, clinicians routinely underdiagnose it and fail to appreciate that it is associated with considerable morbidity and mortality...
August 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28935429/glycemic-control-in-patients-undergoing-coronary-artery-bypass-graft-surgery-clinical-features-predictors-and-outcomes
#9
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...
September 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28799484/pharmacology-and-perioperative-considerations-for-diabetes-mellitus-medications
#10
Stephen Aniskevich, J Ross Renew, Ryan M Chadha, Joan M Irizarry-Alvarado
BACKGROUND: Given the prevalence of diabetes mellitus in modern society, health care providers are frequently tasked with managing glucose control in the perioperative period. When determining perioperative diabetes management, the clinician must balance the need to maintain relative euglycemia at the time of surgery with preventing hypoglycemia or hyperglycemia in a fasting surgical patient. This balance requires an understanding of the pharmacology of these medications, the type of surgery, and the patient's degree of diabetic control...
August 10, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28571661/-evaluation-and-perioperative-management-of-patients-with-diabetes-mellitus-a-challenge-for-the-anesthesiologist
#11
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 disease 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 30, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28555510/perioperative-blood-glucose-concentrations-in-kittens-following-overnight-fasting-and-gonadectomy
#12
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
#13
Andrea M Steely, Lisa Smith, Peter W Callas, Muriel H Nathan, Julie E Lahiri, Andrew C Stanley, Georg Steinthorsson, Daniel J Bertges
BACKGROUND: The aim of this study is to examine the effect of moderate postoperative glycemic control in diabetic and nondiabetic 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 bypass (n = 53, 62%) and OAAA repair (n = 33, 38%) between January 2013 and March 2015...
October 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#14
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...
July 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
#15
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
#16
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 perioperative 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 (POD 1)...
September 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28197025/current-perioperative-management-of-pheochromocytomas
#17
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
#18
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...
April 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
#19
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
#20
Elizabeth W Duggan, Karen Carlson, Guillermo E Umpierrez
No abstract text is available yet for this article.
March 2017: Anesthesiology
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