Postoperatif kan şekeri düzeyinin infeksiyonla ilişkisi

Peroperatif ya da erken postoperatif devrede kan şekeri düzeyi yüksek seyreden non-diyabetik hastalarda infeksiyon riskinin fazla olduğu gösterilmiştir. Bu bağlamda cerrahi yoğun bakım birimlerinde, kan şekerinin normal sınırlar içinde (80-110 mg/dl) tutulması ile cerrahi alan infeksiyon oranlarının azaldığı belirlenmiştir. İnsülin ile kan şekerinin sıkı kontrolü (TGC) adı verilen bu yaklaşımın şiddetli sepsis ya da septik şoku olan hastalardaki yararı tam açıklığa kavuşmamıştır. Çünkü TGC sırasında oluşabilecek hipoglisemi mortaliteyi arttırabilmektedir. Dolayısıyla infeksiyon riskinin azaltılmasında peroperatif ve erken postoperatif devrede kan şekeri düzeyinin 140-150 mg/dl altında tutulmasının yeterli olabileceği genel kabul görmeye başlamıştır.

The relation between postoperative blood sugar level and ınfection

It has been shown that in non-diabetic patients with high level of blood sugar in the per or early postoperative stage, there is a higher rate of infection. In surgical intensive care units when blood sugar is kept within normal limits (80-110 mg/dl) the infection rate decreases. The advantages of this approach Tight Glucose Control (TGC) via insulin in patients with sepsis or septic shock has not yet been clearly demonstrated as hypoglycemia that may ocur during TGC may also increase mortality. Therefore, it has been widely accepted that keeping blood sugar levels below 140-150 mg/dl during per and early postoperative stage may be sufficient in reducing the risk of infection.

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