AORN Journal
Volume 90, Issue 5 , Pages 714-730 , November 2009

Glycemic Control: A Literature Review with Implications for Perioperative Nursing Practice

  • Kristina A. Kittelson, BSN, RN

      Affiliations

    • Kristina A. Kittelson, BSN, RN, is an OR staff nurse at St Mary's Hospital, Grand Junction, CO. Ms Kittelson has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.

References 

  1. Clark NG , Fonseca V , Garber AJ , Inzucchi SE , Moghissi ES . American College of Endocrinology and American Diabetes Association consensus statement on inpatient diabetes and glycemic control . Endocr Pract. . 2006;12(4):459–468
  2. Lipshutz AKM , Gropper MA . Perioperative glycemic control: an evidenced based review . Anesthesiology . 2009;110(2):408–421
  3. Kitabchi AE , Freire AX , Umpierrz GE . Evidence for strict inpatient blood glucose control: time to revise glycemic goals in hospitalized patients . Metabolism . 2008;57(1):116–120
  4. Krinsley JS . Perioperative glucose control . Curr Opin Anaesthesiol . 2006;19(2):111–116
  5. Total prevalence of diabetes & pre-diabetes. American Diabetes Association . http://www.diabetes.org/diabetes-statistics.jsp Accessed August 27, 2009.
  6. Furnary AP , Gao G , Grunkemeier GL , et al.   Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures . Ann Thorac Surg. . 2003;12:1007–1021
  7. Smiley DD , Umpierrez GE . Perioperative glucose control in the diabetic or nondiabetic patient . South Med J. . 2006;99(6):580–589
  8. Faststats: Inpatient surgery. Centers for Disease Control and Prevention . http://www.cdc.gov/nchs/fastats/insurg.htm Accessed August 27, 2009.
  9. Blondet JJ , Beilman GJ . Glycemic control and prevention of perioperative infection . Curr Opin Crit Care . 2007;13(4):421–427
  10. Kraus VL . Perioperative blood glucose control . Perioper Nurs Clin. . 2006;1(3):223–234
  11. Levetan C , Passaro M , Jablonski K , Kass M , Ratner RE . Unrecognized diabetes among hospitalized patients . Diabetes Care . 1998;21(2):246–249
  12. Krinsley JS . Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients . Mayo Clin Proc. . 2003;78(12):1471–1478
  13. Umpierrez GE , Isaacs SD , Bazargan N , You X , Thaler LM , Kitabchi AE . Hyperglycemia: An independent marker of in-hospital mortality in patients with undiagnosed diabetes . J Clin Endocrinol Metab. . 2002;87(3):978–982
  14. Marks JB . Perioperative management of diabetes . Am Fam Physician . 2003;67(1):93–99
  15. Mokshagundam PL . Perioperative management of diabetes mellitus . Crit Care Nurs Q. . 2004;27(2):135–147
  16. Furnary AP , Gao G , Grunkemeier GL , et al.   Continuous insulin infusion reduces mortality in patients with diabetes undergoing coronary artery bypass grafting . J Thorac Cardiovasc Surg. . 2003;125(5):1007–1021
  17. Quattara A , Lecomte P , Le Manach Y , et al.   Poor intraoperative blood glucose control is associated with a worsened hospital outcome after cardiac surgery in diabetic patients . Anesthesiology . 2005;103(4):687–694
  18. Moitra VK , Meiler SE . The diabetic surgical patient . Curr Opin Anesthesiol. . 2006;19(3):339–345
  19. van den Berghe G , Wouters P , Weekers F , et al.   Intensive insulin therapy in critically ill patients . N Engl J Med. . 2001;345(19):1359–1367
  20. Current Specification Manual for National Hospital Quality Measures. Oakbrook Terrace, IL: The Joint Commission . http://www.jointcommission.org/PerformanceMeasurement/PerformanceMeasurement/Current+NHQM+Manual.htm Accessed August 27, 2009.
  21. Hospital-acquired conditions (HAC) in acute inpatient prospective payment system (IPPS) hospitals. Centers for Medicaid & Medicare Services . http://www.cms.hhs.gov/HospitalAcqCond/Downloads/HACFactsheet.pdf Accessed August 27, 2009.
  22. Garber AJ , Moghissi ES , Bransome ED , et al. , American College of Endocrinology Task Force on Inpatient Diabetes Metabolic Control    American College of Endocrinology position statement on inpatient diabetes and metabolic control . Endocr Pract. . 2004;10(Suppl 2):4–9
  23. Rodbard HW , Blonde L , Braithwaite SS , et al. , AACE Diabetes Mellitus Clinical Practice Guidelines Task Force    American Association of Clinical Endocrinologists medical guidelines for clinical practice for the management of diabetes mellitus . Endocr Pract. . 2007;13(Suppl 1):3–68
  24. Pomposelli MD , Baxter JK , Babineau J , et al.   Early postoperative glucose control predicts nosocomial infection rate in diabetic patients . JPEN J Parenter Enteral Nutr. . 1998;22:77–81
  25. Golden SH , Peart-Vigilance C , Kao WHL , Brancati FL . Perioperative glycemic control and the risk of infectious complications in a cohort of adults with diabetes . Diabetes Care . 1999;22(9):1408–1414
  26. Latham R , Lancaster AD , Covington JF , Pirolo JS , Thomas CS . The association of diabetes and glucose control with surgical-site infections among cardiothoracic surgery patients . Infect Control Hosp Epidemiol. . 2001;22(10):607–612
  27. Doenst T , Wijeysundera D , Karkouti K , et al.   Hyperglycemia during cardiopulmonary bypass is an independent risk factor for mortality in patients undergoing cardiac surgery . J Thorac Cardiovasc Surg. . 2005;130(4):1144
  28. Gandhi GY , Nuttall GA , Abel MD , et al.   Intraoperative hyperglycemia and perioperative outcomes in cardiac surgery patients . Mayo Clin Proc. . 2005;80(7):862–866
  29. Lazar HL , Chipkin SR , Fitzgerald CA , Bao Y , Cabral H , Apstein CS . Tight glycemic control in diabetic coronary artery bypass graft patients improves perioperative outcomes and decreases recurrent ischemic events . Circulation . 2004;109(2):1497–1502
  30. Gandhi GY , Nuttall GA , Abel MD , et al.   Intensive intraoperative insulin therapy versus conventional glucose management during cardiac surgery: a randomized trial . Ann Intern Med. . 2007;146(4):233–243
  31. Gandhi GY , Murad MH , Flynn DN , et al.   Effect of perioperative insulin infusion on surgical morbidity and mortality: systematic review and meta-analysis of randomized trials . Mayo Clin Proc. . 2008;83(4):418–430
  32. Ramos M , Khalpey Z , Lipsitz S , et al.   Relationship of perioperative hyperglycemia and postoperative infections in patients who undergo general and vascular surgery . Ann Surg. . 2008;248(4):585–591
  33. McConnell YJ , Johnson PM , Porter GA . Surgical site infections following colorectal surgery in patients with diabetes: association with postoperative hyperglycemia . J Gastrointest Surg. . 2009;13(3):508–515
  34. Pennell L , Smith-Snyder CM , Hudson LR , Hamar GB , Westerfield J . Practice changes in glycemic management and outcomes in coronary artery bypass surgery patients . J Cardiovasc Nurs. . 2005;20(1):26–34
  35. Najarian J , Swavely D , Wilson E , et al.   Improving outcomes for diabetic patients undergoing vascular surgery . Diabetes Spectrum . 2005;18(1):53–60
  36. van de Berghe G , Wilmer A , Hermans G , et al.   Intensive insulin therapy in the medical ICU . N Engl J Med. . 2006;354(5):449–461
  37. Krinsley JS , Grover A . Severe hypoglycemia in critically ill patients: risk factors and outcomes . Crit Care Med. . 2007;35(10):2262–2267
  38. Griesdale DEG , de Souza RJ , van Dam RM , et al.   Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data . CMAJ . 2009;180(8):821–827
  39. Finfer S , Chittock DR , Su SY , NICE-SUGAR Study Investigators  . Intensive versus conventional glucose control in critically ill patients . N Engl J Med. . 2009;360(13):1283–1297
  40. Newhouse RP , Dearholt SL , Poe SS , Pugh LC , White KM . John Hopkins Nursing Evidenced-Based Practice Model and Guidelines . Indianapolis, IN: Sigma, Theta Tau International; 2007;

 Complete this CE activity online at aorn.org/CE indicates that continuing education contact hours are available for this activity. Earn the contact hours by reading this article and taking the examination on pages 727–728 and then completing the answer sheet and learner evaluation on pages 729–730. The contact hours for this article expire November 30, 2012.The latest version of the Portland Protocol for continuous insulin infusion is available for download at http://www.portlandprotocol.org.The behavioral objectives and examination for this program were prepared by Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN, MS, BC, director, Center for Perioperative Education. Ms Holm and Ms Bakewell have no declared affiliations that could be perceived as potential conflicts of interest in publishing this article.This program meets criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.AORN recognizes these activities as continuing education for registered nurses. This recognition does not imply that AORN or the American Nurses Credentialing Center approves or endorses products mentioned in the activity.AORN is provider-approved by the California Board of Registered Nursing, Provider Number CEP 13019. Check with your state board of nursing for acceptance of this activity for relicensure.

PII: S0001-2092(09)00539-0

doi: 10.1016/j.aorn.2009.07.026

AORN Journal
Volume 90, Issue 5 , Pages 714-730 , November 2009

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