Abstract
Introduction: Hyperglycemia during cardiac surgery is common due to stress response and cardiopulmonary bypass. Increased blood glucose is associated with poor outcomes, more complications and increased mortality in diabetic as well as nondiabetic patients due to negative effect on endothelial function, myocardium and inflammatory response. Perioperative blood glucose control and correct target value in cardiac surgery patients remain an ongoing controversy. This study was conducted to observe the effect of two different glycemic protocols in non-diabetic patients undergoing on pump cardiac surgery. Materials and methods: A total of 102 non diabetic patients were randomly distributed into two groups: Group A, Group B. After induction a continuous insulin infusion at the rate of 0.1 unit/kg/hr was started in both groups when blood glucose level (BGL) was >140mg/dl in Group A and >180mg/dl in Group B. The infusion rate was adjusted to maintain BGL at 120-140mg/dl in Group A and 160-180mg/dl in Group B. BGL was measured at different points of time. Perioperative effects, requirement of cardiac drugs, insulin used and infection related complications were assessed. Results: Finally data of 100 patients were analyzed. Rate of deep sternal wound infection [Group A:B= 3(6.12%):4(7.84%)] and other infection related complications were similar in both the groups (p>0.05). Length of ICU stay was significantly longer in Group B than Group A (p=0.013). Conclusion: Perioperative infection rate in nondiabetic cardiac patients is not higher when Target blood glucose level is 160-180mg/dl as compared to120-140mg/dl. Though length of ICU stay is less in lower blood glucose group; perioperative morbidities and 30 day mortality is similar in both blood glucose range.
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