Intensive perioperative glucose control does not improve outcomes of patients submitted to open-heart surgery: a randomized controlled trial
BACKGROUND: The objective of this study was to investigate the relationship between different target levels of glucose and the clinical outcomes of patients undergoing cardiac surgery with cardiopulmonary bypass. METHODS: We designed a prospective study in a university hospital where 109 consecutive...
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| Format: | Article |
| Language: | English |
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Elsevier España
2009-01-01
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| Series: | Clinics |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322009000100010 |
| _version_ | 1818245484239650816 |
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| author | Raquel Pei Chen Chan Filomena Regina Barbosa Gomes Galas Ludhmila Abrahão Hajjar Carmen Narvaes Bello Marilde Albuquerque Piccioni José Otávio Costa Auler Jr. |
| author_facet | Raquel Pei Chen Chan Filomena Regina Barbosa Gomes Galas Ludhmila Abrahão Hajjar Carmen Narvaes Bello Marilde Albuquerque Piccioni José Otávio Costa Auler Jr. |
| author_sort | Raquel Pei Chen Chan |
| collection | DOAJ |
| description | BACKGROUND: The objective of this study was to investigate the relationship between different target levels of glucose and the clinical outcomes of patients undergoing cardiac surgery with cardiopulmonary bypass. METHODS: We designed a prospective study in a university hospital where 109 consecutive patients were enrolled during a six-month period. All patients were scheduled for open-heart surgery requiring cardiopulmonary bypass. Patients were randomly allocated into two groups. One group consisted of 55 patients and had a target glucose level of 80-130 mg/dl, while the other contained 54 patients and had a target glucose level of 160-200 mg/dl. These parameters were controlled during surgery and for 36 hours after surgery in the intensive care unit. Primary outcomes were clinical outcomes, including time of mechanical ventilation, length of stay in the intensive care unit, infection, hypoglycemia, renal or neurological dysfunction, blood transfusion and length of stay in the hospital. The secondary outcome was a combined end-point (mortality at 30 days, infection or length of stay in the intensive care unit of more than 3 days). A p-value of <0.05 was considered significant. RESULTS: The anthropometric and clinical characteristics of the patients from each group were similar, except for weight and body mass index. The mean glucose level during the protocol period was 126.69 mg/dl in the treated group and 168.21 mg/dl in the control group (p<0.0016). There were no differences between groups regarding clinical outcomes, including the duration of mechanical ventilation, length of stay in the intensive care unit, blood transfusion, postoperative infection, hypoglycemic event, neurological dysfunction or 30-day mortality (p>0.05). CONCLUSIONS: In 109 patients undergoing cardiac surgery with cardiopulmonary bypass, both protocols of glycemic control in an intraoperative setting and in the intensive care unit were found to be safe, easily achieved and not to differentially affect clinical outcomes. |
| first_indexed | 2024-12-12T14:33:39Z |
| format | Article |
| id | doaj.art-05e7648f9d144592bb9574f7f5dcde15 |
| institution | Directory Open Access Journal |
| issn | 1807-5932 1980-5322 |
| language | English |
| last_indexed | 2024-12-12T14:33:39Z |
| publishDate | 2009-01-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-05e7648f9d144592bb9574f7f5dcde152022-12-22T00:21:26ZengElsevier EspañaClinics1807-59321980-53222009-01-01641516010.1590/S1807-59322009000100010Intensive perioperative glucose control does not improve outcomes of patients submitted to open-heart surgery: a randomized controlled trialRaquel Pei Chen ChanFilomena Regina Barbosa Gomes GalasLudhmila Abrahão HajjarCarmen Narvaes BelloMarilde Albuquerque PiccioniJosé Otávio Costa Auler Jr.BACKGROUND: The objective of this study was to investigate the relationship between different target levels of glucose and the clinical outcomes of patients undergoing cardiac surgery with cardiopulmonary bypass. METHODS: We designed a prospective study in a university hospital where 109 consecutive patients were enrolled during a six-month period. All patients were scheduled for open-heart surgery requiring cardiopulmonary bypass. Patients were randomly allocated into two groups. One group consisted of 55 patients and had a target glucose level of 80-130 mg/dl, while the other contained 54 patients and had a target glucose level of 160-200 mg/dl. These parameters were controlled during surgery and for 36 hours after surgery in the intensive care unit. Primary outcomes were clinical outcomes, including time of mechanical ventilation, length of stay in the intensive care unit, infection, hypoglycemia, renal or neurological dysfunction, blood transfusion and length of stay in the hospital. The secondary outcome was a combined end-point (mortality at 30 days, infection or length of stay in the intensive care unit of more than 3 days). A p-value of <0.05 was considered significant. RESULTS: The anthropometric and clinical characteristics of the patients from each group were similar, except for weight and body mass index. The mean glucose level during the protocol period was 126.69 mg/dl in the treated group and 168.21 mg/dl in the control group (p<0.0016). There were no differences between groups regarding clinical outcomes, including the duration of mechanical ventilation, length of stay in the intensive care unit, blood transfusion, postoperative infection, hypoglycemic event, neurological dysfunction or 30-day mortality (p>0.05). CONCLUSIONS: In 109 patients undergoing cardiac surgery with cardiopulmonary bypass, both protocols of glycemic control in an intraoperative setting and in the intensive care unit were found to be safe, easily achieved and not to differentially affect clinical outcomes.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322009000100010Cardiac surgeryGlucose controlOpen-heart surgery |
| spellingShingle | Raquel Pei Chen Chan Filomena Regina Barbosa Gomes Galas Ludhmila Abrahão Hajjar Carmen Narvaes Bello Marilde Albuquerque Piccioni José Otávio Costa Auler Jr. Intensive perioperative glucose control does not improve outcomes of patients submitted to open-heart surgery: a randomized controlled trial Clinics Cardiac surgery Glucose control Open-heart surgery |
| title | Intensive perioperative glucose control does not improve outcomes of patients submitted to open-heart surgery: a randomized controlled trial |
| title_full | Intensive perioperative glucose control does not improve outcomes of patients submitted to open-heart surgery: a randomized controlled trial |
| title_fullStr | Intensive perioperative glucose control does not improve outcomes of patients submitted to open-heart surgery: a randomized controlled trial |
| title_full_unstemmed | Intensive perioperative glucose control does not improve outcomes of patients submitted to open-heart surgery: a randomized controlled trial |
| title_short | Intensive perioperative glucose control does not improve outcomes of patients submitted to open-heart surgery: a randomized controlled trial |
| title_sort | intensive perioperative glucose control does not improve outcomes of patients submitted to open heart surgery a randomized controlled trial |
| topic | Cardiac surgery Glucose control Open-heart surgery |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322009000100010 |
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