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Review
. 2017 Mar;126(3):547-560.
doi: 10.1097/ALN.0000000000001515.

Perioperative Hyperglycemia Management: An Update

Elizabeth W Duggan  1 , Karen Carlson, Guillermo E Umpierrez
Affiliations
Review

Perioperative Hyperglycemia Management: An Update

Elizabeth W Duggan et al. Anesthesiology. 2017 Mar.

Erratum in

Abstract

An association between perioperative hyperglycemia and adverse outcomes has been established in surgical patients, - with morbidity being reduced in those treated with insulin.- A practical treatment algorithm and literature summary is provided for surgical patients with diabetes and hyperglycemia.

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Figures

Figure 1
Figure 1
The Surgical Stress Response
Figure 2
Figure 2
Pre and Intraoperative Testing and Treatment Algorithm (Intravenous or Subcutaneous Insulin) (NPO: nothing by mouth, po: oral intake, BG: blood glucose, OR: operating room, PACU: post anesthesia care unit, q2h: every 2 hours, q30min: every 30 minutes, q15min: every 15 minutes, D50: Dextrose 50% Solution, D10: Dextrose 10% Solution, SC: subcutaneous, mg: milligrams, d: deciliter, mmol: millimoles, L: liter) BG 180mg/dL = 10mmol/L, BG 140mg/dL = 7.8mmol/L, 70mg/dL = 3.9mmol/L, BG 50mg/dL = 2.8mmol/L
See this image and copyright information in PMC

Comment in

  • Insulin for Perioperative Glucose Control: Settled Science?
    Gerlach R, Tung A. Gerlach R, et al. Anesthesiology. 2017 Nov;127(5):899-900. doi: 10.1097/ALN.0000000000001845. Anesthesiology. 2017. PMID: 29040103 No abstract available.
  • In Reply.
    Duggan EW, Umpierrez GE. Duggan EW, et al. Anesthesiology. 2017 Nov;127(5):900-901. doi: 10.1097/ALN.0000000000001846. Anesthesiology. 2017. PMID: 29040104 No abstract available.

References

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    1. Frisch A, Chandra P, Smiley D, Peng L, Rizzo M, Gatfcliffe C, Hudson M, Mendoza J, Johnson R, Lin E, Umpierrez G. Prevalence and clinical outcome of hyperglycemia in the perioperative period in noncardiac surgery. Diabetes Care. 2010;33(8):1783–1788. - PMC - PubMed
    1. Kotagal M, Symons RG, Hirsch IB, Umpierrez GE, Farrokhi ET, Flum DR, SCOAP-Certain Collaborative Perioperative hyperglycemia and risk of adverse events among patients with and without diabetes. Ann Surg. 2015;261(1):97–103. - PMC - PubMed
    1. Farrokhi F, Smiley D, Umpierrez GE. Glycemic control in non-diabetic critically ill patients. Best Pract Res Clin Endocrinol Metab. 2011;25(5):813–824. - PMC - PubMed
    1. Furnary AP, Gao G, Grunkemeier GL, Wu Y, Zerr KJ, Bookin SO, Floten HS, Starr A. Continuous insulin infusion reduces mortality in patients with diabetes undergoing coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2003;125(5):1007–1021. - PubMed

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