Perioperative glycemic control and its outcome in patients following open heart surgery

Simple item page
dc.contributor.authorSiddiqui, Khalid Men_US
dc.contributor.authorAsghar, Muhammad Aen_US
dc.contributor.authorKhan, Muhammad Fen_US
dc.contributor.authorKhan, Fazal Hen_US
dc.date.accessioned2019-12-02T09:44:19Z
dc.date.available2019-12-02T09:44:19Z
dc.date.issued2019-07
dc.description.abstractBackground: Diabetes is not uncommon in patients requiring cardiac surgery. These patients have a higher incidence of morbidity and mortality. Subsequently, diabetes represents a major medico-economic problem in both developed and developing countries. This study was designed to observe the association between glycemic control and outcome of patients after open heart surgery in adult population. Materials and Methods: Data was collected retrospectively in all patients who underwent open cardiac surgery (coronary artery bypass grafting, valve, or bypass grafting with valve surgery) and survived 72 hours postoperatively and had diabetes. The study was conducted from January 2015 to December 2016. Results: Of the 129 patients included in the study, male dominated 101 (78.3%). Most frequent surgery was coronary artery bypass grafting (CABG) 123 (95.3%), CABG plus aortic valve replacement 4 (3.1%), and CABG plus mitral valve replacement 2 (1.6%). Considering diabetes, only 3 (2.3%) were on diet control, 112 (86.8%) on oral hypoglycemic agents (OHA), whereas 9 (7%) had control on both insulin and OHA. Only 5 (3.9%) had type I diabetes. The mean fasting blood sugar (FBS) was 154.58 g/dl, and the mean duration of diabetic mellitus was observed 12.32 years. Microvascular and macrovascular complications were 26/129 (20.16%) and 17/129 (13.17%), respectively. Total 75 (58.1%) patients did not require insulin and 54 (41.9%) were treated with insulin intraoperatively to keep the blood glucose level less than 200 g/dl. Cardiac arrhythmias were frequent in the insulin group (P < 0.05), which was also associated with increased stay in the cardiac intensive care unit. Conclusion: Inadequate glycemic control during open cardiac surgery can possibly lead to increased perioperative morbidity and mortality and with decreased long-term survival and recurrent ischemic events. Therefore, aiming for blood glucose levels around 140 mg/dl appears reasonable. Further studies are required to define specific glucose ranges for a clearer definition of recommended blood glucose goals in postoperative cardiac patients for the best outcomes in patients with diabetes mellitus.en_US
dc.identifier.affiliationsDepartment of Anaesthesiology, Aga Khan University, Karachi, Pakistanen_US
dc.identifier.citationSiddiqui Khalid M, Asghar Muhammad A, Khan Muhammad F, Khan Fazal H. Perioperative glycemic control and its outcome in patients following open heart surgery. Annals of Cardiac Anaesthesia. 2019 Jul; 22(3): 260-264en_US
dc.identifier.issn0971-9784
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/185844
dc.languageenen_US
dc.publisherWolters Kluwer - Medknowen_US
dc.relation.issuenumber3en_US
dc.relation.volume22en_US
dc.source.urihttps://dx.doi.org/10.4103/aca.ACA_82_18en_US
dc.subjectInsulinen_US
dc.subjectopen heart surgeryen_US
dc.subjectperioperative glycemic controlen_US
dc.subjectpostoperative outcomeen_US
dc.titlePerioperative glycemic control and its outcome in patients following open heart surgeryen_US
dc.typeJournal Articleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
aca2019v22n3p260.pdf
Size:
512.18 KB
Format:
Adobe Portable Document Format
Download
Collections
Annals of Cardiac Anaesthesia