Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Perioperative Glycemic Status of Adult Traumatic Brain Injury Patients Undergoing Craniotomy: A Prospective Observational Study

Bhattacharjee, Sulagna MD*; Layek, Amitava MD; Maitra, Souvik MD*; Sen, Suvadeep MD; Pal, Sugata MD§; Gozi, Nitis K. MD

Journal of Neurosurgical Anesthesiology: October 2014 - Volume 26 - Issue 4 - p 313–319
doi: 10.1097/ANA.0000000000000057
Clinical Investigations
Buy
SDC

Background: Patients of traumatic brain injury (TBI) may have hyperglycemia and when they undergo craniotomy, hyperglycemia may be exacerbated and worsen outcome. However, epidemiology of perioperative hyperglycemia in these patients is unknown. The epidemiological study has been undertaken to address the correlation between intraoperative blood glucose variability in nondiabetic adult TBI patients undergoing craniotomy with the severity and type of brain trauma and patients’ demographic variables.

Methods: A total of 200 adult nondiabetic patients undergoing emergency craniotomy for TBI were recruited in this prospective single-group observational study. Baseline capillary blood glucose (CBG) measurement was performed immediately before induction of anesthesia and then at half hourly interval until the end of surgery and 1 hour after the end of surgery.

Results: Incidence of at least 1 episode of intraoperative hyperglycemia (CBG≥180 mg/dL) is 20% in patients with TBI during emergency craniotomy. Independent predictors of intraoperative hyperglycemia are severe head injury (Glasgow-Coma score [GCS] <9) and acute subdural hemorrhage. Baseline CBG also correlates with subsequent intraoperative and postoperative CBG.

Conclusions: Hyperglycemia is common during emergency craniotomy in TBI patients. We recommend routine monitoring of blood glucose in the intraoperative and postoperative period at least in severe head injury patients.

Supplemental Digital Content is available in the text.

*Department of Anaesthesiology & Intensive Care

§Department of Anaesthesiology, JPNATC, All India Institute of Medical Sciences

Department of Anaesthesiology, Chacha Nehru Bal Chikitsalaya, New Delhi

Department of Critical Care Medicine, Lilavati Hospital & Research Center, Mumbai

Department of Anaesthesiology, Institute of Post Graduate Medical Education & Research, Kolkata, India

Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website, www.jnsa.com.

The authors have no funding or conflicts of interest to disclose.

Reprints: Souvik Maitra, MD, F 35/2 Third Floor, Gautam Nagar, New Delhi 110049 (e-mail: souvikmaitra@live.com).

Received October 28, 2013

Accepted February 11, 2014

© 2014 by Lippincott Williams & Wilkins