Current Vascular Pharmacology

Dimitri P. Mikhailidis  
Academic Head, Deptartment of Clinical Biochemistry
Royal Free Hospital Campus
University College London Medical School
University College London (UCL)
Pond Street
London, NW3 2QG


Glycaemic Control in Cardiac Surgery Patients: a Double-Edged Sword

Author(s): Lukasz J. Krzych, Maciej T. Wybraniec.


Glycaemic management is of paramount importance in the cardiac surgery setting. A growing body of evidence confirms a J-shaped relationship between blood glucose (BG) level and perioperative morbidity and mortality. On one hand, acute hypoglycaemia causes irreversible cerebral damage. On the other hand, hyperglycaemia increases the risk of infections, acute kidney injury, atrial fibrillation, low cardiac output syndrome, cerebrovascular accidents and cognitive impairment. Also, high BG variability, even within the therapeutic window, may deteriorate the outcome. Therefore, moderate perioperative insulin management is usually recommended, with target BG adjusted to individual needs and possibilities. Continuous BG monitoring is a promising tool that should help practitioners in everyday decision-making process of glycaemic control.

This review summarises the current evidence-based knowledge on the perioperative management of hyperglycaemia.

Keywords: Blood glucose, cardiac surgery, insulin therapy, perioperative period.

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Article Details

Year: 2015
Page: [578 - 586]
Pages: 9
DOI: 10.2174/1570161112666140224145707
Price: $58