Abstract：
STUDY OBJECTIVE:To determine whether our institutional insulin management (modified Atlanta) protocol is efficient and safe in controlling blood glucose levels in the perioperative period in surgical patients undergoing tumor hepatectomy. DESIGN:Retrospective study. SETTING:Large community hospital. PATIENTS:20 consecutive patients undergoing liver resection for hepatocellular carcinoma, liver metastasis, or other hepatobiliary tumors. INTERVENTIONS AND MEASUREMENTS:All patients continuously received intravenous glucose (5% dextrose in water, one mL/kg/hr); insulin was administered according to a strict algorithm, and dose adjustments were based on measurements of whole-blood glucose intraoperatively at one-hour intervals, and in the intensive care unit (ICU). Lower and upper blood glucose limits were set at 85 mg/dL and 110 mg/dL, respectively, in the operating room (OR). In the ICU, lower and upper limits were 90 mg/dL and 140 mg/dL, respectively. MAIN RESULTS:Intraoperatively, 51.3% of measurements were within the target range. In the ICU, 75.2% of measurements showed a blood glucose level of 90 - 140 mg/dL. Two of 78 (2.6%) and two of 363 (0.5%) measurements had a blood glucose level < 70 mg/dL in the OR and ICU, respectively. The lowest blood glucose levels were 65 mg/dL (OR) and 66 mg/dL (ICU). CONCLUSIONS:The modified Atlanta protocol is efficient and safe in controlling blood glucose levels in the perioperative period of hepatic tumor resection. Because of decreased insulin needs in the ICU, the use of a more liberal algorithm successfully reduced the risk of hypoglycemia.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Cammu G,Vermeiren K,Lecomte P,De Gendt S,Deloof T,Foubert Ldoi
10.1016/j.jclinane.2008.09.006subject
Has Abstractpub_date
2009-08-01 00:00:00pages
329-35issue
5eissn
0952-8180issn
1873-4529pii
S0952-8180(09)00165-2journal_volume
21pub_type
杂志文章abstract：STUDY OBJECTIVE:The aim of this study is to compare the effects of intravenous single-dose dexketoprofen trometamol and diclofenac sodium 30 minutes before the end of the surgery on relief of postoperative pain in patients undergoing laparoscopic cholecystectomy. DESIGN:A randomized fashion. SETTING AND PATIENTS:Sixt...
journal_title：Journal of clinical anesthesia
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abstract：STUDY OBJECTIVES:To identify airway management and tracheal intubation techniques for glossopexy in infants with preexisting airway obstruction under general anesthesia. DESIGN:Retrospective, observational study. SETTINGS:Operating room of a university hospital between January 2003 and March 2015. All operations were...
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journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
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abstract：STUDY OBJECTIVE:To survey graduates from our residency program to determine their involvement and their interest in becoming certified in neonatal resuscitation. DESIGN:Survey questionnaire. SETTING:Graduates from the University of Pennsylvania Anesthesia Program between 1989 and 1999. SUBJECTS:212 individuals compl...
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journal_title：Journal of clinical anesthesia
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pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：Journal of clinical anesthesia
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journal_title：Journal of clinical anesthesia
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journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
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更新日期：2003-09-01 00:00:00
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journal_title：Journal of clinical anesthesia
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更新日期：2016-09-01 00:00:00
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journal_title：Journal of clinical anesthesia
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更新日期：1997-11-01 00:00:00
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journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
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更新日期：2016-12-01 00:00:00
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journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
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更新日期：1994-09-01 00:00:00
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journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
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更新日期：2007-11-01 00:00:00
