Document Detail


A review of perioperative glucose control in the neurosurgical population.
MedLine Citation:
PMID:  20144389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Significant fluctuations in serum glucose levels accompany the stress response of surgery or acute injury and may be associated with vascular or neurologic morbidity. Maintenance of euglycemia with intensive insulin therapy (IIT) continues to be investigated as a therapeutic intervention to decrease morbidity associated with derangements in glucose metabolism. Hypoglycemia is a common side effect of IIT with potential for significant morbidity, especially in the neurologically injured patient. Differences in cerebral versus systemic glucose metabolism, the time course of cerebral response to injury, and heterogeneity of pathophysiology in neurosurgical patient populations are important to consider in evaluating the risks and benefits of IIT. While extremes of glucose levels are to be avoided, there are little data to support specific use of IIT for maintenance of euglycemia in the perioperative management of neurosurgical patients. Existing data are summarized and reviewed in this context.
Authors:
Joshua H Atkins; David S Smith
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Publication Detail:
Type:  Journal Article; Review     Date:  2009-11-01
Journal Detail:
Title:  Journal of diabetes science and technology     Volume:  3     ISSN:  1932-2968     ISO Abbreviation:  J Diabetes Sci Technol     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2010-02-10     Completed Date:  2010-09-30     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101306166     Medline TA:  J Diabetes Sci Technol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1352-64     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. atkinsj@uphs.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Glucose / drug effects*,  metabolism
Blood Glucose Self-Monitoring
Brain / drug effects*,  metabolism,  physiopathology,  surgery
Critical Care
Critical Illness
Evidence-Based Medicine
Humans
Hyperglycemia / blood,  diagnosis,  drug therapy*,  physiopathology
Hypoglycemia / blood,  chemically induced,  diagnosis
Hypoglycemic Agents / administration & dosage*,  adverse effects
Insulin / administration & dosage*,  adverse effects
Neurosurgical Procedures* / adverse effects
Perioperative Care
Predictive Value of Tests
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hypoglycemic Agents; 0/Insulin
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