Blood Glucose Management for Reducing Cardiac Surgery Infections.

Abstract

Stress-induced hyperglycemia can occur after cardiac surgery unless the patient is carefully managed. Postoperative hyperglycemia is typically associated with surgical site infections and mediastinitis, resulting in a longer length of stay and escalated costs for the hospitalization. The American Association of Clinical Endocrinologists recommend keeping the intraoperative and postoperative blood glucose levels below 180 mg/dL to avoid postoperative infections. This article describes the effectiveness of a Glucose Management Team tasked with ensuring that blood glucose levels are maintained within these recommended guidelines, starting with day of admission and extending through the first postoperative day. Team members review blood glucose levels and provide clinical data relevant to regulating insulin infusions and nutritional intake, major factors in influencing positive patient outcomes. This article reports the successes of the Glucose Management Team in reducing cardiac surgery infections. The successes of the endeavor led other hospital surgical divisions to adopt the protocol for their patients.