Naslov
Perioperative hyperglycemia in elective arthroplasties. Should we do better?

Autori
Mraović, Boris ; Šimurina, Tatjana ; Joseph, Jeffry I.

Izvornik
Acta anaesthesiologica Scandinavica (0001-5172) 00 (2020); 1-2

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, pismo uredniku, znanstveni

Ključne riječi
blood glucose ; continuous glucose monitoring ; orthopedic surgery.

Sažetak
This short comunication is a comment on recently published article in AAS by Ylikoski et al. The article stressed the importance of hyperglycemia control awareness and the difficulty of implementation even in a modern hospital setting. 1 When participating in a research study, patients usually get more attention, but despite the research setting in this study, hyperglycemia accrued in over 80% of patients, and none of the hyperglycemic patients were treated according to the hospital guidelines. We are intrigued that 14 years after we presented similar data at the American Society of Anesthesiologists meeting in 2006 (ASA 2006) “Glucose Management in Orthopedic Surgery Patients” not much has changed. We reported that 51 patients had high blood glucose (BG) values (≥15.5 mmol/l), but in only 47% of these cases was the primary physician alerted to assess the patient for a possible change in therapy, as it was the standard protocol in our hospital. Moreover, only four patients (8%) had their glucose management adjusted. On the day of surgery, 21 patients had a BG ≥11.1 mmol/l. However, no cases were canceled including two patients with a BG >16.7 mmol/l. One patient was not diagnosed in the medical record as having diabetes although his preoperative BG was 20.4 mmol/l. Furthermore, his BG was not checked on the morning of the surgery, and yet his first BG was 19.9 mmol/l the night of surgery and 26 mmol/l at 4 am on the first postoperative day. Insulin was not started until 9 am when his BG was 30.5 mmol/l. This emphasizes the importance of glucose control even in patients who are not diagnosed as having diabetes.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

Napomena
Letter to the Editor

POVEZANOST RADA