Current cardiology reports
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Cardiac surgery (CS) with cardiopulmonary bypass (CPB) is currently the most common surgery in the United States. Understanding, avoiding, and preventing postoperative complications, including neurologic deficits following CS, represents a great public and economic benefit for society, especially considering our aging population. ⋯ Continuous monitoring of these variables along with systemic hemodynamics will provide a better understanding of mechanisms of brain and other organ injury during CPB. Neuroprotective interventions based on multimodality neurologic monitoring would ideally eliminate postoperative complications and improve patient outcomes.
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It is well established that strict glycemic control for the hospitalized stroke patient is associated with improved outcome compared with poor control. This is particularly true for the stroke patients because hyperglycemia can adversely affect ischemic damage. ⋯ The transition from intravenous insulin to subcutaneous insulin or oral antihyperglycemic agents must be carefully monitored. Careful discharge planning of diabetic care for the stroke patient is necessary to prevent long-term sequelae of inadequate control.