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Perioperative hyperglycemia

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142 papers 0 to 25 followers
https://www.readbyqxmd.com/read/21527113/perioperative-hyperglycemia-and-postoperative-infection-after-lower-limb-arthroplasty
#1
Boris Mraovic, Donghun Suh, Christina Jacovides, Javad Parvizi
BACKGROUND: One of the most serious complications after major orthopedic surgery is deep wound or periprosthetic joint infection. Various risk factors for infection after hip and knee replacement surgery have been reported, including patients' comorbidities and surgical technique factors. We investigated whether hyperglycemia and diabetes mellitus (DM) are associated with infection that requires surgical intervention after total hip and knee arthroplasty. METHODS: We reviewed our computerized database for elective primary total hip and knee arthroplasty from 2000 to 2008...
March 1, 2011: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/19962103/a-study-of-perioperative-hyperglycemia-in-patients-with-diabetes-having-colon-spine-and-joint-surgery
#2
D Kristin Smith, James Bowen, Linda Bucher, Teresa Hawkins, Claudine Jurkovitz, James Reed, Susan Volk
Patients with diabetes often have impaired wound healing and an increased rate of postoperative complications with surgery. Most research has focused on the effect of hyperglycemia in the postoperative period, but there is limited evidence to guide blood glucose (bG) control throughout the perioperative period. This retrospective study explored the effect of hyperglycemia in the PACU on postoperative complications, length of stay (LOS), and in-hospital mortality in patients with diabetes undergoing spine, colon, or joint surgery...
December 2009: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/26198996/postoperative-hyperglycemia-and-adverse-outcomes-in-patients-undergoing-colorectal-surgery-results-from-the-michigan-surgical-quality-collaborative-database
#3
MULTICENTER STUDY
Sathish Mohan, Christodoulos Kaoutzanis, Kathleen B Welch, James F Vandewarker, Suzanne Winter, Greta Krapohl, Richard M Lampman, Michael G Franz, Robert K Cleary
PURPOSE: Our objective was to assess the relationship between high blood glucose levels (BG) in the early postoperative period and the incidence of surgical site infections (SSIs), sepsis, and death following colorectal operations. METHODS: The Michigan Surgical Quality Collaborative database was queried for colorectal operations from July 2012 to December 2013. Normoglycemic (BG < 180 mg/dL) and hyperglycemic (BG ≥ 180 mg/dL) groups were defined by using the highest BG within the first 72 h postoperatively...
November 2015: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/26699765/perioperative-management-of-patients-with-diabetes-and-hyperglycemia-undergoing-elective-surgery
#4
REVIEW
Bithika M Thompson, Joshua D Stearns, Heidi A Apsey, Richard T Schlinkert, Curtiss B Cook
Diabetes mellitus (DM) and hyperglycemia are associated with increased surgical morbidity and mortality. Hyperglycemia is a determinant of risk of surgical complications and should be addressed across the continuum of surgical care. While data support the need to address hyperglycemia in patients with DM in the ambulatory setting prior to surgery and in the inpatient setting, data are less certain about hyperglycemia occurring during the perioperative period-that part of the process occurring on the day of surgery itself...
January 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/26503187/diabetes-and-risk-of-surgical-site-infection-a-systematic-review-and-meta-analysis
#5
REVIEW
Emily T Martin, Keith S Kaye, Caitlin Knott, Huong Nguyen, Maressa Santarossa, Richard Evans, Elizabeth Bertran, Linda Jaber
OBJECTIVE To determine the independent association between diabetes and surgical site infection (SSI) across multiple surgical procedures. DESIGN Systematic review and meta-analysis. METHODS Studies indexed in PubMed published between December 1985 and through July 2015 were identified through the search terms "risk factors" or "glucose" and "surgical site infection." A total of 3,631 abstracts were identified through the initial search terms. Full texts were reviewed for 522 articles. Of these, 94 articles met the criteria for inclusion...
January 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/24299928/the-effect-of-single-low-dose-dexamethasone-on-blood-glucose-concentrations-in-the-perioperative-period-a-randomized-placebo-controlled-investigation-in-gynecologic-surgical-patients
#6
RANDOMIZED CONTROLLED TRIAL
Glenn S Murphy, Joseph W Szokol, Michael J Avram, Steven B Greenberg, Torin Shear, Jeffery S Vender, Jayla Gray, Elizabeth Landry
BACKGROUND: The effect of single low-dose dexamethasone therapy on perioperative blood glucose concentrations has not been well characterized. In this investigation, we examined the effect of 2 commonly used doses of dexamethasone (4 and 8 mg at induction of anesthesia) on blood glucose concentrations during the first 24 hours after administration. METHODS: Two hundred women patients were randomized to 1 of 6 groups: Early-control (saline); Early-4 mg (4 mg dexamethasone); Early-8 mg (8 mg dexamethasone); Late-control (saline); Late-4 mg (4 mg dexamethasone); and Late-8 mg (8 mg dexamethasone)...
June 2014: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/25133932/perioperative-hyperglycemia-and-risk-of-adverse-events-among-patients-with-and-without-diabetes
#7
Meera Kotagal, Rebecca G Symons, Irl B Hirsch, Guillermo E Umpierrez, E Patchen Dellinger, Ellen T Farrokhi, David R Flum
OBJECTIVE: To study the association between diabetes status, perioperative hyperglycemia, and adverse events in a statewide surgical cohort. BACKGROUND: Perioperative hyperglycemia may increase the risk of adverse events more significantly in patients without diabetes (NDM) than in those with diabetes (DM). METHODS: Using data from the Surgical Care and Outcomes Assessment Program, a cohort study (2010-2012) evaluated diabetes status, perioperative hyperglycemia, and composite adverse events in abdominal, vascular, and spine surgery at 53 hospitals in Washington State...
January 2015: Annals of Surgery
https://www.readbyqxmd.com/read/27967226/use-of-a-computer-guided-glucose-management-system-to-improve-glycemic-control-and-address-national-quality-measures-a-7-year-retrospective-observational-study-at-a-tertiary-care-teaching-hospital
#8
Robert J Tanenberg, Sandra Hardee, Caitlin Rothermel, Almond J Drake
Objectives Inpatient hyperglycemia, hypoglycemia, and glucose variability are associated with increased mortality. The use of electronic Glucose Management Systems (eGMS) to guide intravenous (IV) insulin infusion have been found to significantly improve blood glucose (BG) control. This retrospective observational study evaluated the 7-year (1/2009-12/2015) impact of the EndoTool(®) eGMS in intensive and intermediate units at Vidant Medical Center, a 900-bed tertiary teaching hospital. Methods Patients assigned to eGMS had indications for IV insulin infusion, including uncontrolled diabetes, stress hyperglycemia, and/or post-operative BG levels >140 mg/dL...
December 14, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27214771/glycated-hemoglobin-testing-to-identify-undiagnosed-diabetes-mellitus-in-the-inpatient-setting
#9
Dustin Jones, Brian Scharfenberg, Jessica Perkins, Keri Childers, Godwin Y Dogbey, Jay H Shubrook
BACKGROUND: Hyperglycemia is commonly seen in hospitalized patients. Glycated hemoglobin (HbA1c) correlates with the average blood glucose level over the previous 8 to 12 weeks. Thus, an HbA1c test offers a longitudinal view that reduces etiologic ambiguity of disease. Screening of HbA1c levels plays an important role in the diagnosis and management of diabetes mellitus in the outpatient setting but remains underused in the evaluation of hyperglycemia with undiagnosed diabetes in the inpatient setting...
June 1, 2016: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/26971119/the-emory-university-perioperative-algorithm-for-the-management-of-hyperglycemia-and-diabetes-in-non-cardiac-surgery-patients
#10
REVIEW
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
https://www.readbyqxmd.com/read/21530859/what-is-the-best-way-to-guarantee-postoperative-glycemic-control
#11
LETTER
Kazuhiro Hanazaki, Masaya Munekage, Takehiro Okabayashi
No abstract text is available yet for this article.
May 2011: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/25433864/process-versus-outcome-the-sugar-window
#12
EDITORIAL
David A Fullerton, Thoralf M Sundt
No abstract text is available yet for this article.
December 2014: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/20144382/perioperative-and-critical-illness-dysglycemia-controlling-the-iceberg
#13
REVIEW
Mark T Keegan, Michael E Goldberg, Marc C Torjman, Douglas B Coursin
Patients with dysglycemia related to known or unrecognized diabetes, stress hyperglycemia, or hypoglycemia in the presence or absence of exogenous insulin routinely require care during the perioperative period or critical illness. Recent single and multicenter studies, a large multinational study, and three meta-analyses evaluated the safety of routine tight glycemic control (80-110 mg/dl) in critically ill adults. Results led to a call for more modest treatment goals (initiation of insulin at a blood glucose >180 mg/dl with a goal of approximately 150 mg/dl)...
November 1, 2009: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/19962105/glycemic-control-and-surgery-optimizing-outcomes-for-the-patient-with-diabetes
#14
Heather Ead
Diabetes mellitus (DM) has reached epidemic proportions globally, and its incidence continues to rise. Considering the increasing number of patients diagnosed with diabetes and the associated complications, such as cardiovascular and renal disease, the complexity of care for this population can be very challenging. In addition, specific postoperative complications, such as delayed wound healing, infections, and cardiac dysrhythmias, are more likely to occur in the presence of perioperative hyperglycemia. Recognition of the presence of diabetes and implementation of a diabetic management protocol will optimize patient outcomes by providing guidelines for avoiding such complications...
December 2009: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/19940823/intensive-insulin-treatment
#15
T M Merz, S Finfer
Hyperglycaemia is common in acute illness and more severe hyperglycaemia is associated with worse outcomes in critically ill patients in general and after acute myocardial infarction, stroke, and trauma. Normalization of blood glucose by intensive insulin therapy has been shown to reduce morbidity and mortality in one study in surgical intensive care patients; a subsequent study in medical intensive care patients resulted in reduced morbidity but not a reduction in mortality. Multicentre studies and current meta-analyses in the critically ill have not demonstrated improved outcomes when normalization of blood glucose was targeted; furthermore all studies to date have detected an increased risk of hypoglycaemia in patients subjected to intensive insulin therapy...
December 2009: Minerva Anestesiologica
https://www.readbyqxmd.com/read/18832598/intensive-insulin-therapy-in-practice-can-we-do-it
#16
Lesly A Dossett, Bryan Collier, Rafe Donahue, Nathan T Mowery, Marcus J Dortch, Oscar Guillamondegui, Jose J Diaz, Addison K May
BACKGROUND: Intensive insulin therapy (IIT) is the standard of care in the ICU, but precise implementation of insulin protocols has been difficult in clinical practice. The authors' objective was to quantify adherence to an IIT protocol in a practice setting, and to describe how adherence impacts overall blood glucose (BG) control. METHODS: A retrospective analysis of a cohort of critically ill patients treated with IIT was performed. Protocol adherence was evaluated by assessing the timing of BG measurements...
January 2009: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/23292688/perioperative-control-of-blood-glucose-level-in-cardiac-surgery
#17
REVIEW
Kenji Minakata, Ryuzo Sakata
It is well recognized that poor perioperative blood glucose (BG) control can increase the risk of infection, cardiovascular accidents, and even death in patients undergoing cardiac surgery. Since it has been reported that tight BG control (80-110 mg/dL) yields better outcomes in critically ill patients, it became a standard of care to control BG using intravenous insulin infusion in ICU. However, it has been debated in terms of the optimal target range whether a strict control with intensive insulin therapy is better than liberal control...
February 2013: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/21807674/how-low-should-you-go-the-limbo-of-glycemic-control-in-intensive-care-units
#18
REVIEW
Andrew C Faust, Rebecca L Attridge, Laurajo Ryan
Hyperglycemia, a common finding in critically ill patients, is linked to poor outcomes in multiple conditions. The Leuven I study published in 2001 was the first evaluation of intensive insulin therapy, and the 3.4% absolute reduction in mortality in a single-center surgical intensive care unit led to widespread endorsement of the therapy. In a subsequent study in a medical intensive care unit, reduction in mortality was not significant. Two multicenter studies were stopped early because of significantly higher rates of hypoglycemia in the patients receiving intensive insulin therapy...
August 2011: Critical Care Nurse
https://www.readbyqxmd.com/read/17181663/a-review-of-the-use-of-insulin-protocols-to-maintain-normoglycaemia-in-high-dependency-patients
#19
REVIEW
L Jane Whitehorn
AIM: This paper critically examines the evidence base for and issues involved in the introduction of an insulin protocol to maintain normoglycaemia in patients within a medical/surgical high dependency ward. BACKGROUND: A growing body of evidence has linked hyperglycaemia to worsened clinical outcomes. This has led to intravenous insulin protocols becoming a new standard of care in intensive care units. However, the use and benefits of insulin protocols within high dependency units have not yet been addressed in the literature...
January 2007: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/21488803/evaluating-glycemic-control-algorithms-by-computer-simulations
#20
Malgorzata E Wilinska, Jan Blaha, Ludovic J Chassin, Jeremy J Cordingley, Natalie C Dormand, Martin Ellmerer, Martin Haluzik, Johannes Plank, Dirk Vlasselaers, Pieter J Wouters, Roman Hovorka
BACKGROUND: Numerous guidelines and algorithms exist to achieve glycemic control. Their strengths and weaknesses are difficult to assess without head-to-head comparison in time-consuming clinical trials. We hypothesized that computer simulations may be useful. METHODS: Two open-label randomized clinical trials were replicated using computer simulations. One study compared performance of the enhanced model predictive control (eMPC) algorithm at two intensive care units in the United Kingdom and Belgium...
July 2011: Diabetes Technology & Therapeutics
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