[Repercussions and management of perioperative hyperglycemia in cardiac surgery].
Surgery produces a neuroendocrine stress response that affects resistance to insulin, reduces insulin secretion, and increases the release of glucose from the liver. This situation can trigger hyperglycemia in both diabetics and nondiabetics. Hyperglycemia has been linked to an increase in the morbidity and mortality among patients who undergo cardiac surgery, and the benefits of correcting hyperglycemia in this setting by means of intensive insulin therapy are well documented. This review discusses various aspects of hyperglycemia, particularly the evidence supporting stricter control of this condition in patients undergoing cardiac surgery. Furthermore, based on the available data and recommendations, and our clinical experience, we suggest therapeutic strategies to improve the control of hyperglycemia in these patients.
Paniagua
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P
Servicio de Anestesia, Hospital de la Santa Creu i Sant Pau, UAB, Barcelona. ppaniagua@santpau.es
Pérez
A
A
D000222:Adaptation, Physiological; D006348:Cardiac Surgical Procedures; D048909:Diabetes Complications / Q000503:physiopathology; D004032:Diet; D004198:Disease Susceptibility; D004334:Drug Administration Schedule; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D007239:Infections / Q000209:etiology; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage / Q000145:classification / Q000378:metabolism / Q000627:therapeutic use; D007333:Insulin Resistance; D000078790:Insulin Secretion; D007431:Intraoperative Complications / Q000097:blood* / Q000188:drug therapy; D019990:Perioperative Care; D011183:Postoperative Complications / Q000097:blood* / Q000188:drug therapy; D013312:Stress, Physiological / Q000187:drug effects / Q000502:physiology; D014945:Wound Healing
D007328:Insulin