Postoperative Glycemic Control in Cardiac Surgery Patients (Pharmacology Notes) (Report)

Postoperative Glycemic Control in Cardiac Surgery Patients (Pharmacology Notes) (Report)

Blood glucose management in critically ill patients remains an ongoing controversy. In recent years, clinical trials evaluating blood glucose control in critically ill patients advocated for intense blood glucose management, with target blood glucose levels between 80 and 110 mg/dL (1). Intense blood glucose control resulted in a reduction in morbidity and mortality in the critically ill patient population, with a large portion of these patients being cardiovascular surgery patients. Clinical trials evaluating other patient populations have shown a reduction in morbidity with a lesser impact on mortality using tight blood glucose control (2). Additional clinical trials conducted to evaluate the benefit of tight blood glucose control have shown a negative impact on mortality due to hypoglycemia and contribute to the body of evidence disputing the need for tight blood glucose control (3). Given the conflicting results from these recent trials, the target blood glucose range for critically ill patients, specifically postoperative cardiac surgery patients, is still not clearly defined. Blood glucose disturbances from cardiac bypass pump exposure are well documented (4). However, the ability of hyperglycemia to impair leukocyte function via impaired phagocytosis and bacterial killing and lead to infection–specifically surgical or sternal wound infections–was not well established until later (5). Postoperative blood glucose management has been evaluated in diabetic patients, and recent literature includes both diabetic and nondiabetic patients undergoing cardiac surgery. These studies attempt to define optimal postoperative blood glucose goal ranges in both populations.

Postoperative Glycemic Control in Cardiac Surgery Patients (Pharmacology Notes) (Report)

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