Comparing Fair Control of Hyperglycemia contrary to Intensive Control in Patients after Coronary Artery Bypass Grafting Procedure

Omara, Ahmed Sobhy; Shaheen, Yousry Abd-raboh; Abdulhafez, Randa Reda; Mohammed, Mohammed Abd-elmaksoud; El-douskey, Ahmed Ibrahim

doi:10.21608/bmfj.2024.284281.2064

Comparing Fair Control of Hyperglycemia contrary to Intensive Control in Patients after Coronary Artery Bypass Grafting Procedure

Document Type : Original Article

Authors

¹ Associate Professor of Cardiothoracic Surgery Faculty of Medicine - Banha University

² Professor of Cardiothoracic Surgery Faculty of Medicine - Benha University

³ Lecturer of Critical Care Medicine Faculty of Medicine - Banha University

⁴ Department of Critical care medicine Faculty of Medicine - Benha University

10.21608/bmfj.2024.284281.2064

Abstract

Background: Postoperative glycemic control is a critical concern in patients undergoing coronary artery bypass grafting (CABG) surgery. Variations in glycemic management strategies have been studied, with conflicting evidence regarding the optimal glycemic target. This study aimed to compare the effect of tight glycemic control versus fair glycemic control for post cardiac surgery patients.
Methods: This prospective randomized controlled clinical trial included 50 adult CABG patients. The study assessed postoperative outcomes, including ICU stay duration, ventilation time, inotropes/vasopressors use, hypoglycemic episodes, wound infections, and arrhythmias. Patients were randomly allocated into two groups: Group I received insulin infusion to maintain blood sugar between 80-110 mg/dL, while Group II aimed for 140-180 mg/dL.
Results: Both groups have similar mean ages (Group A: 59.2 ± 5.57 years, Group B: 56.24 ± 9.66 years) and gender distribution (Group A: 24.0% females, Group B: 32.0% females). Group B had a longer ICU stay (mean: 56.6 ± 10.51 hours) compared to Group A (mean: 49.24 ± 11.91 hours, p=0.025), and Group B also required more support time (median: 35 hours, IQR: 17-42 hours) compared to Group A (median: 22 hours, IQR: 18-29 hours, p=0.041).
Conclusion: This study demonstrates that fair glycemic control in post cardiac surgery patients after CABG procedure resulted in a significant longer ICU stay and required a longer duration of support compared to tight glycemic control. Despite similar complication rates between the two groups.

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