Speciality
Spotlight

 



 

Orthopaedics

 

 


Cardiac Surgery in Diabetic
Patients
  

  • Furnary AP, Zerr KJ. Grunkemeier
    GL, et al [ Providence St. Vincent Med Ctr., Portland,
    Ore]
    Continuous Intravenous Insulin
    Infusion Reduced Incidence of Deep Sternal Wound
    Infection in Diabetic Patients After Cardiac Surgical
    Procedures

    Ann Thorac Surg 67: 352-362,
    1999
     
    Deep Sternal Wound Infection
    [DSWI] is a very serious complication of cardiac
    surgery, and diabetes is an important risk factor. A
    new protocol to prevent DSWI in patients with
    diabetes, focusing on aggressive control of
    postoperative blood glucose levels by continuous
    insulin infusion [CII] was evaluated.
     
    The
    prospective study included 2 consecutive groups of
    diabetic patients undergoing open heart surgery. The
    first group included 968 patients treated between 1987
    and 1991. In this group, postoperative glucose control
    was achieved by using intermittent subcutaneous
    insulin injections, every 4 hours to maintain a target
    blood glucose level of less than 200 mg/dL. The second
    group of 1499 patients operated on between 1991 to
    1997, received postoperative CII, to maintain blood
    glucose levels between 150 and 200 mg/dL.
     
    The
    two groups were similar in their preoperative and
    intra-operative characteristics. The overall incidence
    of DSWI was 1.3%. Three fourths of these occurred
    after discharge. The control of blood glucose was
    better in the CII group; incidence of DSWI was
    significantly lower in this group, 0.8% vs.1.9%.
     
    A policy of aggressive glucose
    control with CII significantly reduced the incidence
    of DSWI, to equal that in non-diabetics, thus reducing
    considerably the high costs of readmission and
    mortality associated with DSWI in diabetic
    patients.
      



 

         

Speciality Spotlight

 

 
Orthopaedics
 

 

Cardiac Surgery in Diabetic Patients
  

  • Furnary AP, Zerr KJ. Grunkemeier GL, et al [ Providence St. Vincent Med Ctr., Portland, Ore]
    Continuous Intravenous Insulin Infusion Reduced Incidence of Deep Sternal Wound Infection in Diabetic Patients After Cardiac Surgical Procedures
    Ann Thorac Surg 67: 352-362, 1999
     
    Deep Sternal Wound Infection [DSWI] is a very serious complication of cardiac surgery, and diabetes is an important risk factor. A new protocol to prevent DSWI in patients with diabetes, focusing on aggressive control of postoperative blood glucose levels by continuous insulin infusion [CII] was evaluated.
     
    The prospective study included 2 consecutive groups of diabetic patients undergoing open heart surgery. The first group included 968 patients treated between 1987 and 1991. In this group, postoperative glucose control was achieved by using intermittent subcutaneous insulin injections, every 4 hours to maintain a target blood glucose level of less than 200 mg/dL. The second group of 1499 patients operated on between 1991 to 1997, received postoperative CII, to maintain blood glucose levels between 150 and 200 mg/dL.
     
    The two groups were similar in their preoperative and intra-operative characteristics. The overall incidence of DSWI was 1.3%. Three fourths of these occurred after discharge. The control of blood glucose was better in the CII group; incidence of DSWI was significantly lower in this group, 0.8% vs.1.9%.
     
    A policy of aggressive glucose control with CII significantly reduced the incidence of DSWI, to equal that in non-diabetics, thus reducing considerably the high costs of readmission and mortality associated with DSWI in diabetic patients.
      

 

By |2022-07-20T16:42:25+00:00July 20, 2022|Uncategorized|Comments Off on Cardiac Surgery in Diabetic Patients

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