Jorinde A W Polderman1, Markus W Hollmann2, J Hans DeVries3, Benedikt Preckel2, Jeroen Hermanides4. 1. Department of Anaesthesiology, Academic Medical Centre, Amsterdam, Netherlands j.a.polderman@amc.uva.nl. 2. Department of Anaesthesiology and Laboratory of Experimental Intensive Care and Anaesthesiology, Academic Medical Centre, Amsterdam, Netherlands. 3. Department of Endocrinology, Academic Medical Centre, Amsterdam, Netherlands. 4. Department of Anaesthesiology, Academic Medical Centre, Amsterdam, Netherlands.
Abstract
BACKGROUND: The glycemic response and its relation to postoperative complications following gynecologic laparotomies is unknown, although these surgeries carry a substantial risk for postoperative morbidity. Therefore, our objective was to assess the prevalence of perioperative hyperglycemia and glucose variability in women undergoing a gynecologic laparotomy. METHODS: In this prospective cohort study, capillary glucose was measured every hour during the perioperative period. The primary outcome measures were the proportion of patients with postoperative hyperglycemia (glucose >180 mg d l(-1)) and the glucose variability in the intra- and postoperative period. Postoperative complications were assessed as secondary outcome measure. RESULTS: We included 150 women undergoing a gynecologic laparotomy. Perioperative hyperglycemia occurred in 33 patients without diabetes (23.4%) and in 8 patients with diabetes (89%). Glucose variability was significantly higher (mean absolute glucose change [MAG] 11 mg dl(-1) hr(-1) [IQR 8-18]) in the intraoperative compared to the postoperative period (MAG 10 mg dl(-1) hr(-1) [IQR 3-16], P = .03). Neither hyperglycemia nor glucose variability was associated with postoperative complications. CONCLUSIONS: Hyperglycemia and glucose variability seem to be a minor problem during gynecologic laparotomy. Based on the current data, we would not advocate standardized glucose measurements in every patient without diabetes undergoing gynecologic laparotomy.
BACKGROUND: The glycemic response and its relation to postoperative complications following gynecologic laparotomies is unknown, although these surgeries carry a substantial risk for postoperative morbidity. Therefore, our objective was to assess the prevalence of perioperative hyperglycemia and glucose variability in women undergoing a gynecologic laparotomy. METHODS: In this prospective cohort study, capillary glucose was measured every hour during the perioperative period. The primary outcome measures were the proportion of patients with postoperative hyperglycemia (glucose >180 mg d l(-1)) and the glucose variability in the intra- and postoperative period. Postoperative complications were assessed as secondary outcome measure. RESULTS: We included 150 women undergoing a gynecologic laparotomy. Perioperative hyperglycemia occurred in 33 patients without diabetes (23.4%) and in 8 patients with diabetes (89%). Glucose variability was significantly higher (mean absolute glucose change [MAG] 11 mg dl(-1) hr(-1) [IQR 8-18]) in the intraoperative compared to the postoperative period (MAG 10 mg dl(-1) hr(-1) [IQR 3-16], P = .03). Neither hyperglycemia nor glucose variability was associated with postoperative complications. CONCLUSIONS:Hyperglycemia and glucose variability seem to be a minor problem during gynecologic laparotomy. Based on the current data, we would not advocate standardized glucose measurements in every patient without diabetes undergoing gynecologic laparotomy.
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