| A review of perioperative glucose control in the neurosurgical population. | |
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MedLine Citation:
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PMID: 20144389 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Joshua H Atkins; David S Smith |
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Publication Detail:
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Type: Journal Article; Review Date: 2009-11-01 |
Journal Detail:
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Title: Journal of diabetes science and technology Volume: 3 ISSN: 1932-2968 ISO Abbreviation: J Diabetes Sci Technol Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2010-02-10 Completed Date: 2010-09-30 Revised Date: 2013-05-30 |
Medline Journal Info:
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Nlm Unique ID: 101306166 Medline TA: J Diabetes Sci Technol Country: United States |
Other Details:
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Languages: eng Pagination: 1352-64 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. atkinsj@uphs.upenn.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Blood Glucose; 0/Hypoglycemic Agents; 0/Insulin |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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