当前位置： SCI文献检索 > ANESTHESIOLOGY期刊下所有文献 > Poor intraoperative blood glucose control is associated with a worsened hospital outcome after cardiac surgery in diabetic patients.

Poor intraoperative blood glucose control is associated with a worsened hospital outcome after cardiac surgery in diabetic patients.

Abstract：

BACKGROUND:Tight perioperative control of blood glucose improves the outcome of diabetic patients undergoing cardiac surgery. Because stress response and cardiopulmonary bypass can induce profound hyperglycemia, intraoperative glycemic control may become difficult. The authors undertook a prospective cohort study to determine whether poor intraoperative glycemic control is associated with increased intrahospital morbidity. METHODS:Two hundred consecutive diabetic patients undergoing on-pump heart surgery were enrolled. A standard insulin protocol based on subcutaneous intermediary insulin was given the morning of the surgery. Intravenous insulin therapy was initiated intraoperatively from blood glucose concentrations of 180 mg/dl or greater and titrated according to a predefined protocol. Poor intraoperative glycemic control was defined as four consecutive blood glucose concentrations greater than 200 mg/dl without any decrease in despite insulin therapy. Postoperative blood glucose concentrations were maintained below 140 mg/dl by using aggressive insulin therapy. The main endpoints were severe cardiovascular, respiratory, infectious, neurologic, and renal in-hospital morbidity. RESULTS:Insulin therapy was required intraoperatively in 36% of patients, and poor intraoperative glycemic control was observed in 18% of patients. Poor intraoperative glycemic control was significantly more frequent in patients with severe postoperative morbidity (37% vs. 10%; P < 0.001). The adjusted odds ratio for severe postoperative morbidity among patients with a poor intraoperative glycemic control as compared with patients without was 7.2 (95% confidence interval, 2.7-19.0). CONCLUSION:Poor intraoperative control of blood glucose concentrations in diabetic patients undergoing cardiac surgery is associated with a worsened hospital outcome after surgery.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Ouattara A,Lecomte P,Le Manach Y,Landi M,Jacqueminet S,Platonov I,Bonnet N,Riou B,Coriat P

doi

10.1097/00000542-200510000-00006

subject

Has Abstract

pub_date

2005-10-01 00:00:00

pages

687-94

issue

eissn

0003-3022

issn

1528-1175

pii

00000542-200510000-00006

journal_volume

103

pub_type

杂志文章

在线工具

Poor intraoperative blood glucose control is associated with a worsened hospital outcome after cardiac surgery in diabetic patients.