Key result
Intensive insulinotherapy reduced blood glucose and improved cardiac output after CABG compared to conventional insulinotherapy, with no differences in cytokines, CRP, or clinical outcomes.
Why the study?
Does intensive insulinotherapy improve hemodynamic and clinical outcomes compared to conventional insulinotherapy in patients undergoing CABG after cardiopulmonary bypass?
Does intensive insulinotherapy improve hemodynamic and clinical outcomes compared to conventional insulinotherapy in patients undergoing CABG after cardiopulmonary bypass?
Intensive insulin therapy improves early postoperative glycemic control and cardiac output in CABG patients, though it does not appear to significantly alter inflammatory markers or ICU length of stay.
Intensive insulinotherapy was associated with better post-CABG hemodynamics; leaves open clinical outcome benefits in randomized trials.
Hyperglycemia occurs commonly in clinically ill patients. Insulin therapy and glycemic control have been recommended for patients with septic shock. The present study investigated the effect of intensive (INIT) versus conventional insulinotherapy (COIT) in cardiac surgery patients who received cardiopulmonary bypass (CPB). In this quasi-experimental study, a total of 50 patients undergoing coronary artery bypass grafting (CABG) were recruited into the INIT and COIT groups. Study measures included serum glucose levels, cardiac output, cytokines, C-reactive protein (CRP), duration of mechanical ventilation and length of stay in the intensive care unit (ICU), and ICU mortality rate. In the INIT group, mean blood glucose level during the first two postoperative days was significantly lower than that in the COIT group. Cardiac output was significantly greater at the second postoperative days in the INIT patients than those in the COIT group. There were no differences in cytokines, CRP levels and the outcome data between two groups. Intensive insulinotherapy reduced the blood glucose and led to improve cardiac output after CABG in comparison with conventional insulinotherapy.
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Liou et al. (2013) studied Cardiac surgery after cardiopulmonary bypass (n=50). Intensive insulinotherapy vs. Conventional insulinotherapy was evaluated on Serum glucose levels, cardiac output, cytokines, C-reactive protein (CRP), duration of mechanical ventilation, length of stay in the ICU, and ICU mortality rate. Intensive insulinotherapy reduced blood glucose and improved cardiac output after CABG compared to conventional insulinotherapy, with no differences in cytokines, CRP, or clinical outcomes.
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