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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

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30-11-2022 | Hyperglycemia | Review Article/Brief Review

Strategies for intraoperative glucose management: a scoping review

Authors: Nathaniel Morin, BSc, Sarah Taylor, BScH, Danae Krahn, MD, Leyla Baghirzada, MD, Michael Chong, MD, Tyrone G. Harrison, MD, Anne Cameron, MD, MSc, Shannon M. Ruzycki, MD, MPH

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 2/2023

Abstract

Purpose

Perioperative hyperglycemia is associated with adverse outcomes for patients with and without diabetes. Guidelines and published protocols for intraoperative glycemic management have substantial variation in their recommendations. We sought to characterize the current evidence-guiding intraoperative glycemic management in a scoping review.

Sources

Our search strategy included MEDLINE (Ovid and EBSCO), PubMed, PubMed Central, EMBASE, CINAHL, Cochrane Library, SciVerse Scopus, and Web of Science and a gray literature search of Google, Google Scholar, hand searching of the reference lists of included articles, OAISter, institutional protocols, and ClinicalTrails.gov.

Principal findings

We identified 41 articles that met our inclusion criteria, 24 of which were original research studies. Outcomes and exposures were defined heterogeneously across studies, which limited comparison and synthesis. Investigators often created arbitrary and differing categories of glucose values rather than analyzing glucose as a continuous variable, which limited our ability to combine results from different studies. In addition, the study populations and surgery types also varied considerably, with few studies performed during day surgeries and specific surgical disciplines. Study populations often included more than one type of surgery, indication, and urgency that were expected to have varying physiologic and inflammatory responses. Combining low- and high-risk patients in the same study population may obscure the harms or benefits of intraoperative glycemic management for high-risk procedures or patients.

Conclusion

Future studies examining intraoperative glycemic management should carefully consider the study population, surgical characteristics, and pre- and postoperative management of hyperglycemia.

Available only for authorised users

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Title: Strategies for intraoperative glucose management: a scoping review
Authors: Nathaniel Morin, BSc
Sarah Taylor, BScH
Danae Krahn, MD
Leyla Baghirzada, MD
Michael Chong, MD
Tyrone G. Harrison, MD
Anne Cameron, MD, MSc
Shannon M. Ruzycki, MD, MPH
Publication date: 30-11-2022
Publisher: Springer International Publishing
Keywords: Hyperglycemia
Dexamethasone
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 2/2023
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-022-02359-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Strategies for intraoperative glucose management: a scoping review

Abstract

Purpose

Sources

Principal findings

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Sources

Principal findings

Conclusion

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