Intensive hyperglycemia control reduces postoperative infections after open heart surgery
Abstract:
Overview
Background. Diabetes mellitus increases the risk of infections in patients undergoing
cardiac surgery. We hypothesized that intensive perioperative hyperglycemia control by intravenous
insulin infusion reduces postoperative infections in all patients undergoing open heart
surgical procedures.
Methods. Sixty diabetics patients who underwent CABG operation (Group 1) were compared
with fifty-five patients who underwent other cardiac surgery (Group 2) between January 2004
and March 2005. A continuous infusion of insulin was used in all these patients.
Results. There were no 30-day mortalities in either group. There was no difference in the incidence
of infections between the two groups: in Group 1, 3 (5%) patients were diagnosed to have
postoperative infection (superficial sternal wound infections in 1 (1.66%) and lung infection in 2
(3.33%) patients); postoperative infection occurred in only 2 patients (3.63%) in Group 2, 1 superficial
sternal wound infections (1.81%) and 1 lung infection (1.81%).
Conclusions. Our analysis indicates that continuous intravenous insulin infusion improves outcome
and reduces postoperative infections in patients undergoing CABG as well as those undergoing
other cardiac surgery procedures. (Heart International 2006; 2: 49-53)
Keywords
Hyperglycemia, Infections, Heart surgery
Article:
Article Information:
Correspondence
Fabio Capuano, MD, Via Flaminia, 1227, 00188 Roma – Italy, capmd@katamail.com