Τίτλος:
Effects of intensive glycemic control on outcomes of cardiac surgery
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objectives: To investigate the effects of postoperative intensive glycemic control on patient outcomes. Background: Ineffective perioperative glycemic control has been associated with high mortality and morbidity rates among cardiac surgery patients. Methods: 212 cardiac surgery patients were allocated by a quasi-experimental design to: a) a control group (. n = 107) with targeted blood glucose levels 161-200 mg/dl or b) a therapy group (. n = 105) with blood glucose target 120-160 mg/dl. We compared the two groups on their mortality, length of stay, duration of intubation, incidence of severe hypoglycemia and frequency of postoperative infections. Results: The mean postoperative blood glucose levels were significantly lower for the therapy group compared with the control group (153.9 mg/dl vs. 173.9 md/dl, p < 0.001). The intensive glycemic control was strongly associated with decreased in-hospital mortality (7 deaths/105 patients for the control group vs. 1 death/105 patients for the therapy group; p = 0.033). We did not identify any statistically significant associations regarding the other patient outcomes. Conclusions: This randomized quasi-experimental trial found lower in-hospital mortality with more intense blood glucose control. Effective postoperative glycemic control did not affect the other studied patient outcomes. © 2013 Elsevier Inc.
Συγγραφείς:
Giakoumidakis, K.
Eltheni, R.
Patelarou, E.
Theologou, S.
Patris, V.
Michopanou, N.
Mikropoulos, T.
Brokalaki, H.
Περιοδικό:
Heart and Lung: Journal of Acute and Critical Care
Λέξεις-κλειδιά:
glucose; insulin, adult; aged; article; controlled study; disease severity; endotracheal intubation; female; glucose blood level; glycemic control; heart surgery; human; hypoglycemia; incidence; intensive care; length of stay; major clinical study; male; morbidity; mortality; perioperative period; postoperative care; postoperative hemorrhage; postoperative infection; priority journal; randomized controlled trial; surgical patient; treatment outcome, Aged; Blood Glucose; Cardiac Surgical Procedures; Clinical Protocols; Female; Hospital Mortality; Humans; Hypoglycemia; Hypoglycemic Agents; Infection Control; Insulin; Intensive Care Units; Length of Stay; Male; Middle Aged; Monitoring, Physiologic; Outcome Assessment (Health Care); Postoperative Care; Postoperative Complications; Time Factors; Treatment Outcome
DOI:
10.1016/j.hrtlng.2012.12.007
