| Perioperative glycemic control: an evidence-based review. | |
| | |
MedLine Citation:
|
PMID: 19194167 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Hyperglycemia in perioperative patients has been identified as a risk factor for morbidity and mortality. Intensive insulin therapy (IIT) has been shown to reduce morbidity and mortality among the critically ill, decrease infection rates and improve survival after cardiac surgery, and improve outcomes in acute neurologic injury and acute myocardial infarction. However, recent evidence of severe hypoglycemia and adverse events associated with IIT brings its safety and efficacy into question. In this article, we summarize the mechanisms and rationale of hyperglycemia and IIT, review the evidence behind the use of IIT in the perioperative period, and discuss the implications of including glycemic control in national quality benchmarks. We conclude that while avoidance of hyperglycemia is clearly beneficial, the appropriate glucose target and specific subpopulations who might benefit from IIT have yet to be identified. Given the potential for harm, inclusion of glucose targets in national quality benchmarks is premature. |
| | |
Authors:
|
Angela K M Lipshutz; Michael A Gropper |
Related Documents
:
|
3509277 - Scintillating scotoma as the first symptom of systemic lupus erythematosus. 18675267 - Different inflammatory reactions to vitamin d3 among the lateral, third and fourth vent... 15711037 - Filter run time in cvvh: pre- versus post-dilution and nadroparin versus regional hepar... 10603507 - Bleeding complications to long-term oral anticoagulant therapy. 11980687 - Quantification of left ventricular systolic function by tissue doppler echocardiography... 20399607 - Right ventricular outflow tract pacing causes intraventricular dyssynchrony in patients... |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Review |
Journal Detail:
|
Title: Anesthesiology Volume: 110 ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2009 Feb |
Date Detail:
|
Created Date: 2009-02-05 Completed Date: 2009-03-05 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
|
Languages: eng Pagination: 408-21 Citation Subset: AIM; IM |
Affiliation:
|
Department of Medicine, Stanford University Medical Center, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Blood Glucose
/
analysis,
metabolism* Cost-Benefit Analysis Critical Illness Humans Hyperglycemia / blood, physiopathology, prevention & control* Hypoglycemic Agents / therapeutic use Insulin / therapeutic use Intensive Care Intraoperative Complications / mortality, prevention & control Perioperative Care* Postoperative Complications / mortality, prevention & control Risk Factors |
| Chemical | |
Reg. No./Substance:
|
0/Blood Glucose; 0/Hypoglycemic Agents; 11061-68-0/Insulin |
| Comments/Corrections | |
Comment In:
|
Anesthesiology. 2009 Feb;110(2):204-6
[PMID:
19194142
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Alpha-1-adrenergic receptor agonist activity of clinical alpha-adrenergic receptor agonists interfer...
Next Document: Glutamate, microdialysis, and cerebral ischemia: lost in translation?