TY  - CHAP
M1  - Book, Section
TI  - Perioperative Management of Endocrine Diseases
A1  - Cheng, Hugo Q.
A2  - Papadakis, Maxine A.
A2  - McPhee, Stephen J.
A2  - Rabow, Michael W.
A2  - McQuaid, Kenneth R.
PY  - 2022
T2  - Current Medical Diagnosis & Treatment 2022
AB  - Poor  preoperative  glycemic  control,  as  indicated  by  an  elevated  hemoglobin  A1c  level,  is  associated  with  a  greater  risk  of  surgical  complications,  particularly  infections.  However,  a  strategy  of  delaying  surgery  until  glycemic  control  improves  has  not  been  rigorously  studied.  The  ideal  postoperative  blood  glucose  target  is  also  unknown.  Trials  have  demonstrated  that  tighter  perioperative  glycemic  control  leads  to  better  clinical  outcomes  in  cardiac  surgery  patients  in  a  critical  care  unit.  This  finding  is  not  generally  applicable  to  other  surgical  patients,  however,  since  a  subsequent  trial  demonstrated  increased  mortality  with  tight  control  in  surgical  patients  in  an  intensive  care  unit.  Data  are  lacking  on  risks  and  benefits  of  tight  control  in  patients  outside  of  intensive  care  units.  Based  on  trials  that  showed  increased  mortality  in  hospitalized  patients  randomized  to  tight  control,  the  American  College  of  Physicians  recommends  maintaining  serum  glucose  between  140  mg/dL  and  200  mg/dL  (7.8–11.1  mmol/L),  whereas  the  British  National  Health  Service  guidelines  recommend  a  range  of  108–180  mg/dL  (6–10  mmol/L).  Even  for  coronary  artery  bypass  patients,  the  Society  of  Thoracic  Surgeons  recommends  a  blood  glucose  range  of  121–180  mg/dL  (6.7–10  mmol/L).  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1184156219
ER  -