Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2011
ReviewIntegrating outcome benefit into anesthetic design: the promise of steroids and statins.
Steroids and statins may facilitate the integration of anesthetic design with clinical outcome. Although steroids clearly benefit adult cardiac surgical patents, the evidence is weaker in pediatric cardiac surgery. Current large randomized trials of steroids likely will determine the future role of steroids in adult cardiac surgery. ⋯ Statins are essential in vascular surgery because they reduce mortality, myocardial ischemia, and acute renal injury. As a result, they have been recommended highly for outcome enhancement in recent perioperative guidelines. Although they may improve survival in sepsis, further investigation is indicated to define their therapeutic role.
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J. Cardiothorac. Vasc. Anesth. · Oct 2011
HbA1c and diabetes predict perioperative hyperglycemia and glycemic variability in on-pump coronary artery bypass graft patients.
Perioperative hyperglycemia and glycemic variability are considered independent predictors of morbidity and mortality in critically ill patients. The purpose of this study was to investigate the relation of HbA1c and/or a prior diagnosis of diabetes mellitus and intra- and postoperative hyperglycemia and glycemic variability. ⋯ Diabetic status and/or elevated HbA1c are predictors of postoperative glucose variability and hyperglycemia in CABG surgery patients. However, in the intraoperative period, these groups show similar glycemic responses to operative stress.