Journal of clinical anesthesia
-
To examine the effect on morbidity and mortality of an established intraoperative insulin protocol in cardiac surgical patients. ⋯ Implementation of an intraoperative IV insulin protocol, while associated with improved glycemic control, was not associated with improved outcomes. While improved glycemic control on initiating CPB was associated with decreased 30-day mortality, the effect was small. Implementation of our insulin protocol was highly associated with decreased renal failure postoperatively. Further prospective studies are warranted to better establish causality.
-
Postintubation tracheal stenosis presents major challenges to the anesthesiologist, especially in situations where the airway is shared with the surgeon. The airway management of a patient with severe postintubation subglottic stenosis, who developed complete airway obstruction during attempted tracheal dilatation, is presented.