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Review
. 2018 Mar;47(1):203-222.
doi: 10.1016/j.ecl.2017.10.005.

Perioperative Management of Hyperglycemia and Diabetes in Cardiac Surgery Patients

Rodolfo J Galindo  1 , Maya Fayfman  1 , Guillermo E Umpierrez  2
Affiliations
Review

Perioperative Management of Hyperglycemia and Diabetes in Cardiac Surgery Patients

Rodolfo J Galindo et al. Endocrinol Metab Clin North Am. 2018 Mar.

Abstract

Perioperative hyperglycemia is common after cardiac surgery, reported in 60% to 90% of patients with diabetes and in approximately 60% of patients without history of diabetes. Many observational and prospective randomized trials in critically-ill cardiac surgery patients support a strong association between hyperglycemia and poor clinical outcome. Despite ongoing debate about the optimal glucose target, there is strong agreement that improved glycemic control reduces perioperative complications.

Keywords: CABG; Cardiac surgery; Diabetes; Hospital diabetes; Perioperative hyperglycemia; Stress hyperglycemia.

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Figures

Fig. 1
Fig. 1
Mechanism of stress hyperglycemia and its complications in surgical patients.
Fig. 2
Fig. 2
Hospital discharge algorithm based on admission HbA1c (A1C). OAD, oral antidiabetic drugs. (Adapted from Umpierrez GE, Reyes D, Smiley D, et al. Hospital discharge algorithm based on admission HbA1c for the management of patients with type 2 diabetes. Diabetes Care 2014;37(11):2934–9; with permission.)
See this image and copyright information in PMC

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