The Effect of Tight Glycemic Control on Surgical Site Infection Rates in Patients Undergoing Open Heart Surgery

The Effect of Intraoperative Tight Glycemic Control on Surgical Site Infection Rates in Patients Undergoing Open Heart Surgery

The purpose of this study was to investigate the effects of three different glycemic treatment conditions (tight, conventional, and standard) in the intraoperative period on: 1) postoperative surgical site infections, and 2) postoperative procalcitonin, and C-reactive protein levels in patients undergoing open-heart surgery. Secondary aims of the study were to investigate the effects of the three glycemic treatment conditions on: 1) intraoperative blood glucose; 2) intraoperative glycemic stability; and 3) intensive care unit length of stay, in patients undergoing open-heart surgery.

An experimental design with a multilevel, single factor, within-subjects design was utilized. Patients were nested within anesthesia provider teams. The design was counterbalanced by means of a Latin square, where each of three anesthesia provider teams dispensed each of three glycemic treatment conditions once.

Inclusion Criteria:

• over the age of 21
• on cardiopulmonary bypass or off cardiopulmonary
• elective or urgent coronary artery bypass graft (CABG) surgery
• CABG with or without combined valve surgery
• valve surgery

Exclusion Criteria:

• chronically immunosuppressed
• suffered from end-stage organ disease
• currently had active infections
• underwent emergent or salvage CABG surgery
• had an implanted insulin pump
• were in another interventional clinical trial.