title: Effects of intensive glycemic control on outcomes of cardiac surgery.
abstract: OBJECTIVE
  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.
authors: Cardiac Surgery ICU, "Evangelismos" General Hospital of Athens, 45-47 Ipsilantou Street, 10646 Athens, Greece. kongiakoumidakis@gmail.com
authors: Konstantinos
authors: K
authors: Giakoumidakis
authors: Rokeia
authors: R
authors: Eltheni
authors: Evridiki
authors: E
authors: Patelarou
authors: Stavros
authors: S
authors: Theologou
authors: Vasileios
authors: V
authors: Patris
authors: Nektaria
authors: N
authors: Michopanou
authors: Theodoros
authors: T
authors: Mikropoulos
authors: Hero
authors: H
authors: Brokalaki
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D002985:Clinical Protocols; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects; D017053:Infection Control / Q000379:methods; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000097:blood / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin