How important is glycemic control during coronary artery bypass?

Harold L Lazar
Author Information
  1. Harold L Lazar: Department of Cardiothoracic Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA. harold.lazar@bmc.org

Abstract

In summary, poor perioperative glycemic control in patients undergoing CABG is associated with increased morbidity and mortality. Maintaining serum glucose less than or equal to 180 mg/dL in patients with diabetes during CABG reduces morbidity and mortality, lowers the incidence of wound infections, reduces hospital length of stay, and enhances long-term survival. In nondiabetic patients undergoing CABG surgery, maintaining serum glucose less than 180 mg/dL has also resulted in improved perioperative outcomes. More aggressive glycemic control (80-120 mg/dL) provides no added improvement in CABG patients with less than or equal to 3 days of ICU care in the absence of ventilatory support or multiorgan failure. Although the precise value for achieving glycemic control in the perioperative period is the subject of much debate, the benefits of perioperative glycemic control with continuous insulin infusions in patients undergoing CABG is no longer debatable.

MeSH Term

Blood Glucose
Coronary Artery Bypass
Coronary Artery Disease
Diabetic Angiopathies
Endothelium, Vascular
Glucose
Humans
Hyperglycemia
Insulin
Myocardial Ischemia
Postoperative Period
Potassium
Practice Guidelines as Topic
Treatment Outcome

Chemicals

Blood Glucose
Insulin
glucose-insulin-potassium cardioplegic solution
Glucose
Potassium

Word Cloud

Created with Highcharts 10.0.0glycemiccontrolpatientsCABGperioperativeundergoinglessmg/dLmorbiditymortalityserumglucoseequal180reducessummarypoorassociatedincreasedMaintainingdiabeteslowersincidencewoundinfectionshospitallengthstayenhanceslong-termsurvivalnondiabeticsurgerymaintainingalsoresultedimprovedoutcomesaggressive80-120providesaddedimprovement3daysICUcareabsenceventilatorysupportmultiorganfailureAlthoughprecisevalueachievingperiodsubjectmuchdebatebenefitscontinuousinsulininfusionslongerdebatableimportantcoronaryarterybypass?

Similar Articles

Cited By