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Perioperative management of blood glucose during open heart surgery in infants and children
Author(s) -
Steven James,
Nicolson Susan
Publication year - 2011
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2011.03587.x
Subject(s) - medicine , glycemic , hypoglycemia , perioperative , adverse effect , intensive care medicine , incidence (geometry) , clinical trial , cardiac surgery , prospective cohort study , blood management , pediatrics , anesthesia , emergency medicine , insulin , surgery , optics , physics
Summary The perioperative management of blood glucose has been controversial since clinical associations between hyperglycemia and adverse outcomes were first reported more than two decades ago. Despite some early evidence supporting a causal relationship between hyperglycemia and adverse outcomes, prospective trials of tight glycemic control have been inconclusive, except in selected populations, like adult diabetics. These trials have consistently reported dramatic increases in the incidence and severity of hypoglycemia, which may also have associated adverse outcomes. Bedside glucose monitors typically used to manage glucose have increasingly been found to introduce systematic inaccuracies. Relevant studies of infants and children undergoing cardiac surgery are considerably fewer in number, requiring clinicians to extrapolate from other clinical conditions and patient populations.