creating a perioperative glycemic control program创建一个围手术期血糖控制程序.pdfVIP

Hindawi Publishing Corporation Anesthesiology Research and Practice Volume 2011, Article ID 465974, 9 pages doi:10.1155/2011/465974 Review Article Creating a Perioperative Glycemic Control Program Sara M. Alexanian,1 Marie E. McDonnell,1 and Shamsuddin Akhtar2 1 Department of Endocrinology, Diabetes and Nutrition, Boston University Medical Center, 88 East Newton Street, Evans 201, Boston, MA 02118, USA 2 Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510, USA Correspondence should be addressed to Sara M. Alexanian, sara.alexanian@ Received 15 April 2011; Revised 15 June 2011; Accepted 6 July 2011 Academic Editor: Rainer Lenhardt Copyright © 2011 Sara M. Alexanian et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Hyperglycemia in the surgical population is a recognized risk factor for postoperative complications; however, there is little lit- erature to date regarding the management of hyperglycemia in the perioperative period. Here, we detail the strategies that our institutions have employed to identify and treat hyperglycemia in patients with diabetes who present for surgery. Our approach focuses on the recognition of hyperglycemia and metabolic abnormalities, control of glucose levels via insulin infusion when needed, monitoring for hypoglycemia and a comprehensive multidisciplinary approach that provides standardized recommenda- tions for patients at all points in care as they transition from the preoperative clinic into the operating room, and then into the hospital. 1. Background noncar