Kedi ve Köpeklerde Perioperatif Glisemik Yönetim
SIVAS II. INTERNATIONAL CONFERENCE ON SCIENTIFIC AND INNOVATION RESEARCH, Sivas, Türkiye, 15 - 17 Eylül 2023, ss.1099-1113, (Tam Metin Bildiri)
- Yayın Türü: Bildiri / Tam Metin Bildiri
- Doi Numarası: 10.5281/zenodo.8409212
- Basıldığı Şehir: Sivas
- Basıldığı Ülke: Türkiye
- Sayfa Sayıları: ss.1099-1113
- İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet
Özet
PERIOPERATIVE GLYCEMIC MANAGEMENT IN CATS AND DOGS
Phd. Cand. Esra ACAR* (ORCID: 0000-0002-9322-3910)
Istanbul University-Cerrahpasa, Faculty of Veterinary Medicine, Graduate Education Institute, İstanbul-Türkiye Email: esra.acar.vet@gmail.com
Research Assistant Eylem BEKTAŞ BİLGİÇ (ORCID: 0000-0002-2745-9511) Istanbul University-Cerrahpasa, Faculty of Veterinary Medicine, Department of Surgery, İstanbul-Türkiye Email: eylem.bilgic@iuc.edu.tr
ABSTRACT Under normal conditions, blood glucose concentration is kept between 70 mg/dL-110 mg/dL (3.9-6.1 mmol/L) by the hormone insulin secreted by the body. However, glucose homeostasis is also directly affected by hormones such as glucagon, catecholamines, cortisol, growth hormone, which are called counter-regulatory hormones. Conditions and diseases such as stress, hyperadrenocorticism, steroid applications, diabetes mellitus lead to hyperglycemia, while diseases in which glucose production decreases or consumption increases such as excessive insulin secretion, hypoadrenocorticism, liver failure and sepsis lead to hypoglycemia. The deleterious effects of hyperglycemia are manifested in different ways that can lead to various immune, vascular and neurologic abnormalities that cause systemic inflammation and alterations in endothelial cell function. In particular, blood glucose levels above 250 mg/dL lead to osmotic diuresis due to glucosuria and consequent electrolyte imbalances such as dehydration, hyponatremia, hypokalemia and hypophosphatemia. Anesthesia induces the stress response through a complex interaction involving the neuroendocrine system and autonomic nervous system, leading to hyperglycemia, especially in diabetic patients. In addition, pain and stress cause hyperglycemia even in non-diabetic patients due to an increase in circulating catecholamines by stimulation of the sympathetic nervous system. On the other hand, clinical symptoms such as weakness, behavioral changes, tachycardia, seizures, tremors, coma that occur in hypoglycemia can be concealed by anesthesia and pose a life risk for patients. Studies have shown that perioperative hyperglycemia and hypoglycemia are risk factors for morbidity and mortality. Anesthesia protocols should be designed taking into account the conditions of these patients. In this review, how to perform perioperative glycemic monitoring of patients will be discussed and the practices to be performed to reduce morbidity and mortality rates will be evaluated in the light of current data.
Keywords: anesthesia, hyperglycemia, hypoglycemia, insulin