Abstract
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.
Current Vascular Pharmacology
Title:Glycaemic Control in Cardiac Surgery Patients: a Double-Edged Sword
Volume: 13 Issue: 5
Author(s): Lukasz J. Krzych and Maciej T. Wybraniec
Affiliation:
Keywords: Blood glucose, cardiac surgery, insulin therapy, perioperative period.
Abstract: 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.
Export Options
About this article
Cite this article as:
Krzych J. Lukasz and Wybraniec T. Maciej, Glycaemic Control in Cardiac Surgery Patients: a Double-Edged Sword, Current Vascular Pharmacology 2015; 13 (5) . https://dx.doi.org/10.2174/1570161112666140224145707
DOI https://dx.doi.org/10.2174/1570161112666140224145707 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Genomic Variations Affecting Biological Effects of Statins
Current Drug Metabolism Clinical Assessment of Central Blood Pressure
Current Hypertension Reviews Lipoprotein(a) Management: Pharmacological and Apheretic Treatment
Current Medicinal Chemistry Folate Nutrigenetics: A Convergence of Dietary Folate Metabolism, Folic Acid Supplementation, and Folate Antagonist Pharmacogenetics
Drug Metabolism Letters Frequency Domain Mapping of Atrial Fibrillation - Methodology, Experimental Data and Clinical Implications
Current Cardiology Reviews Suppression of Virulence of Porphyromonas gingivalis by Potent Inhibitors Specific for Gingipains
Current Protein & Peptide Science Effects of Endothelins on Cardiac and Vascular Cells: New Therapeutic Target for the Future?
Current Vascular Pharmacology Approaches and Recent Trends in Gene Delivery for Treatment of Atherosclerosis
Recent Patents on Drug Delivery & Formulation Editorial: Inflammation and Heart Diseases
Current Pharmaceutical Design Mast Cell Chymase and Tryptase as Targets for Cardiovascular and Metabolic Diseases
Current Pharmaceutical Design Systematic Review of Public Education and Policy for Stroke Prevention
Current Drug Targets Common Variants in Toll-Like Receptor 4 Confer Susceptibility to Alzheimer’s Disease in a Han Chinese Population
Current Alzheimer Research miR-126 as a Therapeutic Agent for Diabetes Mellitus
Current Pharmaceutical Design Pharmacogenetics in Psychiatry - A Useful Clinical Tool or Wishful Thinking for the Future?
Current Pharmaceutical Design Hemodynamic Monitoring in the Acute Management of Pediatric Heart Failure
Current Cardiology Reviews Three Dimensional Echocardiography: Recent Trends in Segmen tation Methods
Current Medical Imaging The Entero-Hepatic Nuclear Receptors Integrate Cholesterol, Lipid, and Bile Acid Homeostasis
Current Medicinal Chemistry - Immunology, Endocrine & Metabolic Agents Intracerebral Hemorrhage and Diabetes Mellitus: Blood-Brain Barrier Disruption, Pathophysiology and Cognitive Impairments
CNS & Neurological Disorders - Drug Targets Preface
Current Nutrition & Food Science Future Preventive and Therapeutic Targets for Transfusion-Related Acute Lung Injury
Current Pharmaceutical Design