Intensive Perioperative Glucose Control Does Not Improve Outcomes of Patients Submitted to Open-Heart Surgery: A Randomized Controlled Trial

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. We designed a prospective study in a university hospital where 109 consecutive patients were enroll...

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Published in:Clinics (São Paulo, Brazil) Brazil), 2009-01, Vol.64 (1), p.51-60
Main Authors: Chan, Raquel Pei Chen, Galas, Filomena Regina Barbosa Gomes, Hajjar, Ludhmila Abrahão, Bello, Carmen Narvaes, Piccioni, Marilde Albuquerque, Auler, José Otávio Costa
Format: Article
Language:English
Subjects:
Blood Glucose - metabolism
Cardiac surgery
Cardiac Surgical Procedures
Cardiopulmonary Bypass
Cardiovascular Diseases - blood
Cardiovascular Diseases - surgery
Clinical Science
Female
Glucose control
Humans
Male
MEDICINE, GENERAL & INTERNAL
Middle Aged
Monitoring, Physiologic
Open-heart surgery
Perioperative Care
Prospective Studies
Treatment Outcome
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Summary: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. 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
ISSN:1807-5932
1980-5322
1980-5322
DOI:10.1590/S1807-59322009000100010