Importance of perioperative blood glucose management in cardiac surgical patients.
Tight blood glucose control has become a therapeutic goal for anesthetic management of patients undergoing cardiovascular surgery. We discuss the evidence for a link between blood glucose levels and rates of morbidity and mortality in cardiac surgical patients in the intensive care unit. Hyperglycemia per se has been associated with higher rates of deep wound infection, neurologic, renal, and cardiac complications following surgery, as well as longer intensive care unit stay. We review the specifics of glucose management in patients undergoing cardiac surgery and hypothermic cardiopulmonary bypass, including the role that insulin may play in regulating blood glucose levels intraoperatively and the relationship between insulin and outcome.
Shine
Timothy S J
TS
Department of Anesthesiology, Mayo Clinic, Jacksonville, USA.
Uchikado
Mihoko
M
Crawford
Claudia C
CC
Murray
Michael J
MJ
D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000009:adverse effects; D048909:Diabetes Complications / Q000097:blood / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D006331:Heart Diseases / Q000097:blood / Q000401:mortality / Q000601:surgery*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood; D007333:Insulin Resistance; D016343:Monitoring, Intraoperative / Q000379:methods; D019990:Perioperative Care; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin