Intraoperative glycemic control in patients undergoing Orthotopic liver transplant: a single center prospective randomized study

Table 2 Intraoperative glucose management protocol for strict glycemic control

¹When glucose level is < 80 mg/dL, stop insulin infusion and initiate 50 mL/h of 10% dextrose infusion. Check glucose every 30 min until glucose level is ≥80 mg/dL - Discontinue 10% dextrose infusion. Resume insulin infusion, always in column 1. If glucose level is < 70 mg/dL, initiate treatment of hypoglycemia protocol. Restart insulin infusion in column 1 when glucose level ≥ 80 mg/dL
† Start in this column; restart in this column when insulin infusion has to be discontinued for glucose level < 80 mg/dL
‡ Patient has not reached glucose level range of 80–110 mg/dL within 2 h of using column 1 and glucose level has decreased by < 50 mg/dL over preceding 1 h
§ Patient had not reached glucose level range of 80–110 mg/dL within 2 h of using column 2 and glucose level has decreased by < 50 mg/dL over preceding 1 h
Target: 80–120 mg/dL
Trigger: One blood glucose > 130 or two blood glucoses > 120 when checked 30 min apart. Bolus doses should not be necessary using this protocol
Hypoglycemia protocol (If blood glucose < 70 mg/dL): Hold infusion, give 25 ml of 50% dextrose IV bolus (1/2 vial) and start 50mls/hr. 10% glucose. Re-check BG every 15 min until BG > 70 mg/dL, then every 30 min

ISSN: 1471-2253