title: Usefulness of perioperative blood glucose control in patients undergoing off-pump coronary artery bypass grafting.
abstract: 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.
authors.affiliation: 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
authors.forename: Takeshiro
authors.initials: T
authors.lastname: Fujii
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Noritsugu
authors.initials: N
authors.lastname: Shiono
authors.forename: Muneyasu
authors.initials: M
authors.lastname: Kawasaki
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yokomuro
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Ozawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hamada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Masuhara
authors.forename: Nobuya
authors.initials: N
authors.lastname: Koyama
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin