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By Dennis T. Mangano M.D., Ph.D (auth.), Theodore H. Stanley MD, W. Clayton Petty MD (eds.)

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Extra info for Anesthesia and the Cardiovascular System: Annual Utah postgraduate course in anesthesiology 1984

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2) Renal disease may be present limiting insulin metabolism. 3) Autonomic neuropathy may cause cardiovascular instability intra- and post operatively. 35 4) Well managed diabetics in the intraoperative and perioperative period of cardiac surgery will benefit from improved wound healing and be less susceptable to postoperative sepsis thus avoiding prolonged hospilisation. References 1. Alberti KGMM, Thomas DJB The management of diabetes during surgery. Br. J. Anaesth. 51: 693-710, 1979 2. Haljamae H Quantitation of surgical stress by the use of blood and tissue glucose and glycolytic metabolite levels.

Kehlet H, Brandt MR, Prange Hansen A, Alberti KGMM Effect of epidural analgesia on metabolic profiles during and after surgery. Br. J. Surg. 66: 543-546, 1979 5. Larner J, Haynes RC Jr Insulin and oral hypoglycaemic drugs~ glucagon. In: The Pharmacological Basis of Therapeutics. Fifth edition, eds. Goodman LS, Gilman A, New York, Maxmillan Publ. , 1975 6. Taitelmann U, Reece EA, Bessman AN Insulin in the management of the diabetic surgical patient. Continuous intravenous infusion versus sUbcutaneous administration.

Disturbance of renin/angiotensin system 4. Disturbance of sympathetic nervous system controls. Secondary Hypertension (15% to 20%) Possible causes can be identified: Kidney Disease 1. Acute and chronic infection 2. , renal artery stenosis, trauma 3. , polycystic kidney 4. , polyarteritis nodosa, disseminated lupus, etc. Endocrine Disease 1. Hyperaldosteronism (Conn's syndrome) 2. Pheochromocytoma 3. Toxemia of pregnancy Neurogenic Causes 1. , tetanus 2. , postmyocardial revascularization hypertension (13) 3.

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