Effect of perioperative control of blood glucose level on patient’s outcome after anesthesia for cardiac surgery

Abstract

BackgroundBlood glucose control is an important factor in improving outcome of diabetic patients undergoing cardiac surgery.ObjectiveIs to estimate the relation between blood glucose control and perioperative outcomes in these patients.Study designProspective cohort study.MethodsOne hundred diabetic patients undergoing cardiac surgery, were divided equally into group I (control group) in whom no tight glycemic control was done and group II (study group) in which tight glycemic control was done. Patients in the study group received intra-operatively an infusion of rapidly acting insulin according to a modified protocol to keep blood glucose level between 80 and 110 mg/dl and continued in the ICU until complete recovery from anesthesia. Patients in the control group followed the same protocol of insulin infusion only if their peri-operative blood glucose level exceeded 180 mg/dl.ResultsThere was a rise of blood glucose level in the control group patients till the end of operations (mean level = 227 mg/dl). Mean blood glucose level before CPB was comparable in the two groups, but was significantly different after that until extubation. We reported three cases of delayed recovery in the control group compared to one case in the study group. We also recorded four cases of cardiac problems in group I compared to one case in group II (P = 0.044). There was statistically significant difference between groups regarding renal, neurological and surgical post-operative complications.ConclusionTight glycemic control is recommended for better patient’s outcome after cardiac anesthesia.