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2014, Number 07

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MediSan 2014; 18 (07)

Algorithm for the metabolic control of the diabetic patient in the postoperative period of the cardiovascular surgery

Rodulfo GM, de Dios LJA, Rodríguez AOD, Torralbas RFE
Full text How to cite this article

Language: Spanish
References: 8
Page: 148-151
PDF size: 142.01 Kb.


Key words:

cardiovascular surgery, diabetes mellitus, surgical stress, postoperative period, algorithm, secondary health care.

ABSTRACT

The patient with diabetes mellitus frequently presents uncontrolled glycemia levels in the postoperative period of the cardiovascular surgery, due to the metabolic consequences caused by them, either the increase of counter-regulative hormones as the resistance and/or decrease of the insulin levels, caused by the surgical stress to which the organism is exposed. Its control is essential during the surgery and after it, because the clinical course of the affected depends on it; therefore, it is of vital importance to have a guide that allows guidance to maintain the glycemia figures in appropriate values. A therapeutic algorithm of easy use is presented, elaborated in the Cardiovascular Surgery Service of "Saturnino Lora Torres" Clinical Surgical Teaching Provincial Hospital in Santiago de Cuba, with the objective of treating hyperglycemia, which can be generalized to the rest of the institutions in the country.


REFERENCES

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  2. Jiménez Quevedo P, Sabaté M. Revascularización coronaria en diabéticos: evidencias, indicaciones y complicaciones. Rev Esp Cardiol. 2007;7(Supl E):41-8.

  3. Pacheco Mejías A, García Rodríguez ME, Montenegro Pacheco A. Manejo del paciente diabético en cirugía. Arch Cir Gen Dig. 2006. [citado 8 feb 2013]. Disponible en: http://www.cirugest.com/htm/revista/2006/13/2006-09-18.htm

  4. Carvalho G, Pelletier P, Albacker T, Lachapelle K, Joanisse DR, Hatzakorzian R, et al. Cardioprotective effects of glucose and insulin administration while maintaining normoglycemia (GIN Therapy) in patients undergoing coronary artery bypass grafting. JCEM. 2011;96:1469-77.

  5. Asociación Latinoamericana de diabetes. Guías ALAD de diagnóstico, control y tratamiento de la diabetes mellitus tipo 2. 2010 [citado 8 feb 2013]. Disponible en: http://www.slideshare.net/MOSQUETERO36/guias-alad-2010-consenso-de-diabetesactualizado

  6. Braunwald E. Diabetes and the cardiovascular system. In: A textbook of Cardiovascular Medicine. 9th ed. 2011. p. 1392-1407.

  7. Rojas Pérez EM, Luna Ortiz P, Serrano Valdez X, Fernández Rivera BJ, de Micheli A. Solución de glucosa-insulina-potasio (GIK): Efectos cardioprotectores de la insulina. Arch Cardiol Méx. 2006;76(Supl.4):144-51.

  8. American Diabetes Association. Standards of Medical Care in Diabetes-2009. Diabetes Care. 2009;32(suppl 1):S13-S61.




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MediSan. 2014;18