Vigilant monitoring and protocol-driven treatment of hyperglycemia during cardiopulmonary bypass is justified to potentially reduce adverse post-surgical outcomes such as infection, cardiac dysfunction, and mortality.
May support protocol-driven glucose management during bypass for clinicians; leaves open confirmation of benefits in prospective trials.
Cardiopulmonary bypass (CPB) is associated with surgical stress, hypothermia, hyperoxia, enhancement of neuroendocrine outflow, and administration of glucogenic catecholamines that are associated with glucogonolysis and glucogenesis that result in hyperglycemia. The hyperglycemic state during CPB has been associated with adverse outcomes, such as infection, neurological impairment, cardiac dysfunction, prolonged hospitalization, and higher mortality rates. This report justifies vigilant monitoring of blood glucose levels and a rational protocol for the treatment of hyperglycemia of all open heart surgical patients that may improve post-CPB surgical outcomes.
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Najmaii et al. (2006) studied this question.
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