Perioperative implications of sodium-glucose cotransporter-2 inhibitors: a case series of euglycemic diabetic ketoacidosis in three patients after cardiac surgery.
Aaron LauSimon BruceErica WangRon ReeKevin RondiAnthony ChauPublished in: Canadian journal of anaesthesia = Journal canadien d'anesthesie (2017)
Anesthesiologists should recognize that patients receiving SGLT2i preoperatively are at risk of developing euDKA. Hence, based on the pharmacokinetics of SGLT2i, discontinuing the medication at least two days prior to surgery should minimize the risk. Diagnosing euDKA is challenging and often delayed because of its nonspecific signs and symptoms. When suspected, serum and urine ketones should be monitored to reduce the time to diagnosis and treatment.
Keyphrases
- end stage renal disease
- ejection fraction
- minimally invasive
- newly diagnosed
- chronic kidney disease
- type diabetes
- prognostic factors
- patients undergoing
- peritoneal dialysis
- cardiac surgery
- pulmonary embolism
- coronary artery bypass
- acute kidney injury
- emergency department
- surgical site infection
- acute coronary syndrome
- sleep quality