Intraoperative hyperglycemia increases the incidence of postoperative delirium

Windmann, Victoria; Spies, Claudia; Knaak, Cornelia; Wollersheim, Tobias; Piper, Sophie K.; Vorderwülbecke, Gerald; Kurpanik, Maryam; Kuenz, Sophia; Lachmann, Gunnar

doi:10.23736/s0375-9393.19.13748-0

Cited by 24 publications

(17 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings might have clinical implications. There is evidence that hyperglycemia is associated with adverse clinical outcome, poor cognitive outcome in particular 1 , 2 , 4 , 31 , 32 . In the future, cerebrovascular markers might be used to predict preoperative risk for intraoperative hyperglycemia.…”

Section: Discussionmentioning

confidence: 99%

“…Hyperglycemia occurs frequently during surgery and has been related to poor clinical outcome such as acute kidney injury, cognitive impairment and increased rates of wound infection resulting from compromised immune functioning [1][2][3][4]. Glycemic control in critically ill patients reduced postoperative complications and improved survival, particularly in septic patients [5].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The association between intraoperative hyperglycemia and cerebrovascular markers

Knaak¹,

Kant²,

Lammers-Lietz³

et al. 2021

Int. J. Med. Sci.

Self Cite

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE: Hyperglycemia can lead to an increased rate of apoptosis of microglial cells and to damaged neurons. The relation between hyperglycemia and cerebrovascular markers on MRI is unknown. Our aim was to study the association between intraoperative hyperglycemia and cerebrovascular markers. METHODS: In this further analysis of a subgroup investigation of the BIOCOG study, 65 older non-demented patients (median 72 years) were studied who underwent elective surgery of ≥ 60 minutes. Intraoperative blood glucose maximum was determined retrospectively in each patient. In these patients, preoperatively and at 3 months follow-up a MRI scan was performed and white matter hyperintensity (WMH) volume and shape, infarcts, and perfusion parameters were determined. Multivariable logistic regression analyses were performed to determine associations between preoperative cerebrovascular markers and occurrence of intraoperative hyperglycemia. Linear regression analyses were performed to assess the relation between intraoperative hyperglycemia and pre- to postoperative changes in WMH volume. Associations between intraoperative hyperglycemia and postoperative WMH volume at 3 months follow-up were also assessed by linear regression analyses. RESULTS: Eighteen patients showed intraoperative hyperglycemia (glucose maximum ≥ 150 mg/dL). A preoperative more smooth shape of periventricular and confluent WMH was related to the occurrence of intraoperative hyperglycemia [convexity: OR 33.318 (95 % CI (1.002 - 1107.950); p = 0.050]. Other preoperative cerebrovascular markers were not related to the occurrence of intraoperative hyperglycemia. Intraoperative hyperglycemia showed no relation with pre- to postoperative changes in WMH volume nor with postoperative WMH volume at 3 months follow-up. CONCLUSIONS: We found that a preoperative more smooth shape of periventricular and confluent WMH was related to the occurrence of intraoperative hyperglycemia. These findings may suggest that a similar underlying mechanism leads to a certain pattern of vascular brain abnormalities and an increased risk of hyperglycemia.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The association between intraoperative hyperglycemia and cerebrovascular markers

Knaak¹,

Kant²,

Lammers-Lietz³

et al. 2021

Int. J. Med. Sci.

Self Cite

View full text Add to dashboard Cite

show abstract

“…Porter et al studied the effects of severe degenerative scoliosis on surface landmarks for lumbar plexus block and recommended Another significant perioperative challenge is the diagnosis, prevention, and therapy of postoperative cognitive dysfunction (PcD) or delirium (PoD). While diabetes is a known predisposing factor for PocD and PoD, 105,106 the effects of acute intraoperative hyperglycemia are still unknown. spies et al conducted a prospective observational study enrolling 87 patients ≥65 years old undergoing elective surgery.…”

Section: Regional Anesthesiamentioning

confidence: 99%

A year in review in Minerva Anestesiologica 2020. Anesthesia, analgesia, and perioperative medicine

Cavaliere¹,

Allegri²,

Apan³

et al. 2021

Minerva Anestesiol

View full text Add to dashboard Cite

“…Another significant perioperative challenge is the diagnosis, prevention, and therapy of postoperative cognitive dysfunction (PcD) or delirium (PoD). While diabetes is a known predisposing factor for PocD and PoD, 105,106 the effects of acute intraoperative hyperglycemia are still unknown. spies et al conducted a prospective observational study enrolling 87 patients ≥65 years old undergoing elective surgery.…”

Section: Regional Anesthesiamentioning

confidence: 99%

A year in review in Minerva Anestesiologica 2019. Anesthesia, analgesia, and perioperative medicine

Cavaliere

Allegri²,

Apan

et al. 2020

Minerva Anestesiol

View full text Add to dashboard Cite

Intraoperative hyperglycemia increases the incidence of postoperative delirium

Cited by 24 publications

References 40 publications

The association between intraoperative hyperglycemia and cerebrovascular markers

The association between intraoperative hyperglycemia and cerebrovascular markers

A year in review in Minerva Anestesiologica 2020. Anesthesia, analgesia, and perioperative medicine

A year in review in Minerva Anestesiologica 2019. Anesthesia, analgesia, and perioperative medicine

Contact Info

Product

Resources

About