Continuous insulin infusion is associated with a reduced post-surgical length of stay, but not with the complication rate, in patients with diabetes mellitus undergoing coronary artery bypass graft

被引:3
作者
Abelev, Z. [1 ]
Seth, A. [1 ]
Patel, R. [1 ]
Goldstein, S. [2 ]
Bogun, M. [3 ]
Paliou, M. [1 ]
Schlosser, J. [1 ]
Homel, P. [4 ]
Busta, A. [1 ]
Seto-Young, D. [1 ]
Tranbaugh, R. [5 ]
Poretsky, L. [1 ]
机构
[1] Beth Israel Deaconess Med Ctr, Div Endocrinol & Metab, Friedman Diabet Inst, New York, NY 10003 USA
[2] Lehigh Univ, Bethlehem, PA 18015 USA
[3] Poznan Univ Med Sci, Poznan, Poland
[4] Beth Israel Deaconess Med Ctr, Dept Pain Med & Palliat Care, New York, NY 10003 USA
[5] Beth Israel Deaconess Med Ctr, Div Cardiovasc Surg, New York, NY 10003 USA
关键词
CABG; continuous insulin infusion; diabetes mellitus; insulin; ACUTE MYOCARDIAL-INFARCTION; BODY-MASS INDEX; PERIOPERATIVE GLYCEMIC CONTROL; CRITICALLY-ILL PATIENTS; TIGHT GLUCOSE CONTROL; BLOOD-GLUCOSE; CARDIAC-SURGERY; RISK-FACTOR; MORTALITY; HYPERGLYCEMIA;
D O I
10.3275/7760
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To establish if glucose management with continuous intravenous insulin infusion (CII) in the early post-operative period after coronary artery bypass graft (CABG) surgery is associated with complication rate and 'length of hospital stay (LOS) in patients with diabetes mellitus (DM). Research design and methods: We reviewed the records of 587 patients with DM who underwent CABG from January 1999 until January 2008; 316 patients were placed on CII, while 271 patients were treated with subcutaneous insulin. We examined patient age, glycated hemoglobin (HgbA1c), 24- and 72-h post-operative average 'capillary blood glucose (CBG), length of stay (LOS), and the rate of complications. Results: There was no difference in HgbA1c between the groups. Mean CBG values at both 24 h and 72 h remained the same in the CII group (167 mg/di), while in the non-CII group they were 194 mg/dl and 189 mg/di, respectively (p<0.001 between the groups). Post-surgical median LOS was 6 days in the CII group and 6.5 days in the non-CII group (p=0.003). Complications occurred at similar rate (in 10% and 11% of patients) in the two groups. Conclusions: CII is associated with a reduced post-surgical LOS in patients with DM who undergo CABG. (J. Endocrinol. Invest. 34: 770-774, 2011) (C)2011, Editrice Kurtis
引用
收藏
页码:770 / 774
页数:5
相关论文
共 52 条
[31]  
Mehta SR, 2005, JAMA-J AM MED ASSOC, V293, P437
[32]   AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN DIABETES ASSOCIATION CONSENSUS STATEMENT ON INPATIENT GLYCEMIC CONTROL [J].
Moghissi, Etie S. ;
Korytkowski, Mary T. ;
DiNardo, Monica ;
Einhorn, Daniel ;
Hellman, Richard ;
Hirsch, Irl B. ;
Inzucchi, Silvio E. ;
Ismail-Beigi, Faramarz ;
Kirkman, M. Sue ;
Umpierrez, Guillermo E. .
ENDOCRINE PRACTICE, 2009, 15 (04) :353-369
[33]  
New York State Department of Health, 2011, CARD DIS DAT STAT
[34]   EFFECTS OF GLUCOSE AND FATTY-ACIDS ON MYOCARDIAL-ISCHEMIA AND ARRHYTHMIAS [J].
OLIVER, MF ;
OPIE, LH .
LANCET, 1994, 343 (8890) :155-158
[35]   High glucose impairs superoxide production from isolated blood neutrophils [J].
Perner, A ;
Nielsen, SE ;
Rask-Madsen, J .
INTENSIVE CARE MEDICINE, 2003, 29 (04) :642-645
[36]   Influence of individual characteristics on outcome of glycemic control in intensive care unit patients with or without diabetes mellitus [J].
Rady, MY ;
Johnson, DJ ;
Patel, BM ;
Larson, JS ;
Helmers, RA .
MAYO CLINIC PROCEEDINGS, 2005, 80 (12) :1558-1567
[37]   Effect of body mass index on early outcomes in patients undergoing coronary artery bypass surgery [J].
Reeves, BC ;
Ascione, R ;
Chamberlain, MH ;
Angelini, GD .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2003, 42 (04) :668-676
[38]  
SATOMI N, 1985, JNCI-J NATL CANCER I, V74, P1255
[39]   EFFECTS OF A COMPUTERIZED ORDER SET ON THE INPATIENT MANAGEMENT OF HYPERGLYCEMIA: A CLUSTER-RANDOMIZED CONTROLLED TRIAL [J].
Schnipper, Jeffrey L. ;
Liang, Catherine L. ;
Ndumele, Chima D. ;
Pendergrass, Merri L. .
ENDOCRINE PRACTICE, 2010, 16 (02) :209-218
[40]   The Society of Thoracic Surgeons 2008 Cardiac Surgery Risk Models: Part 1-Coronary Artery Bypass Grafting Surgery [J].
Shahian, David M. ;
O'Brien, Sean M. ;
Filardo, Giovanni ;
Ferraris, Victor A. ;
Haan, Constance K. ;
Rich, Jeffrey B. ;
Normand, Sharon-Lise T. ;
DeLong, Elizabeth R. ;
Shewan, Cynthia M. ;
Dokholyan, Rachel S. ;
Peterson, Eric D. ;
Edwards, Fred H. ;
Anderson, Richard P. .
ANNALS OF THORACIC SURGERY, 2009, 88 (01) :S2-S22