Usefulness of perioperative blood glucose control in patients undergoing off-pump coronary artery bypass grafting.
OBJECTIVE
We investigated the usefulness of perioperative blood glucose control in patients undergoing coronary artery bypass grafting (CABG).


METHODS
DM patients were aggressively treated with intensive insulin therapy to achieve a preoperative fasting blood glucose level of 140 mg/dl and a postoperative level of 200 mg/dl. For comparison, patients were divided as follows: (1) DM group vs. non-DM group, and (2) for mean blood glucose level in the intensive care unit (ICU), lower than 200 mg/dl (IL) vs. 200 mg/dl or higher (IH).


RESULTS
(1) In the DM group, the amount of insulin (U) used during surgery was greater (P<0.05), and the duration of ICU stay was longer (P<0.05). The incidence of all complications was higher in the DM group (P<0.05). (2) Between the IH group (54) and the IL group (82), the proportion of DM patients was higher in the IH group (75% vs. 38%, P<0.05). In the IH, the duration of ICU stay (P<0.01) was longer, and the incidence of all complications was higher (P<0.05). (3) In the DM group, the incidence of complications tended to be higher in the IH group. The incidence of complications was extremely low in the non-DM group.


CONCLUSIONS
Strict perioperative blood glucose control may help to improve the outcomes of CABG.
Fujii
Takeshiro
T
Toho University School of Medicine, Department of Surgery, Division of Cardiovascular Surgery, 6-11-1 Omorinishi, Ota-ku, Tokyo 143-8541, Japan. fujiit@aol.com
Watanabe
Yoshinori
Y
Shiono
Noritsugu
N
Kawasaki
Muneyasu
M
Yokomuro
Hiroki
H
Ozawa
Tsukasa
T
Hamada
Satoshi
S
Masuhara
Hiroshi
H
Koyama
Nobuya
N
D000368:Aged; D001786:Blood Glucose / Q000187:drug effects*; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy / Q000601:surgery*; D048909:Diabetes Complications / Q000453:epidemiology / Q000209:etiology; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D015994:Incidence; D007328:Insulin / Q000627:therapeutic use*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin