Javaherforoosh Zadeh Fatemeh, Azemati Simin
Department of Anesthesia, Ahvaz Anesthesiology and Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
J Diabetes Metab Disord. 2020 Jan 20;19(1):423-430. doi: 10.1007/s40200-020-00494-4. eCollection 2020 Jun.
Many of the patients who are undergoing Coronary Artery Bypass Graft have diabetes mellitus or metabolic syndrome and are at risk for hyperglycemia events.
The present study aimed to compare conventional glucose control with adjusted tight control in patients undergoing on-pump CABG.
This double -blind randomized clinical trial study was conducted in Shiraz, Iran, from September 2017-March 2018. Two consecutive groups of 75 patients undergoing elective on- pump coronary artery bypass graft surgery.
The patients were divided into adjusted tight control of the blood glucose between 100 and 120 mg/dl and conventional method that the blood glucose maintained ≤200 mg/dl.
mortality, sternal wound infection, cardiac arrhythmia, cerebrovascular attack, and acute renal failure.
duration of mechanical ventilation and length of ICU staying. The same main outcomes were evaluated after one month.
The data were analyzed using SPSS version 20(SPSS, Chicago, IL). Group comparisons were performed using t-tests and Chi-square tests. Repeated measurement test was used for comparing blood glucose in two groups. Mann Whitney U test was compared duration of the mechanical ventilation and length of ICU staying. Statistical significance was defined as a value <0.05.
There were no significant differences between main and secondary outcomes. About late outcomes, sternal wound infection was in the control group (7 patients) more than intervention (1 patient) ( < 0.05). No differences between other complications in both groups were observed. The occurrence of hypoglycemia was low in both groups. Hypokalemia was significantly higher in the intervention than in control ( < 0.001).
The findings showed using adjusted tight glycemic control to a level that is nearby to normal values during cardiac surgery may reduce episodes of hypoglycemia and thus reduces its side effects. As well as reduce hyperglycemic complications such as sternal wound infection.
IRCT2013041713052N1). 2013-07-09.
许多接受冠状动脉旁路移植术的患者患有糖尿病或代谢综合征，存在发生高血糖事件的风险。
本研究旨在比较接受体外循环冠状动脉旁路移植术（CABG）患者的传统血糖控制与调整后的严格控制。
这项双盲随机临床试验于2017年9月至2018年3月在伊朗设拉子进行。连续两组，每组75例接受择期体外循环冠状动脉旁路移植手术的患者。
患者被分为血糖调整为严格控制在100至120mg/dl之间的组和血糖维持≤200mg/dl的传统方法组。
死亡率、胸骨伤口感染、心律失常、脑血管意外和急性肾衰竭。
机械通气时间和重症监护病房（ICU）住院时间。一个月后评估相同的主要结局指标。
使用SPSS 20版（SPSS，伊利诺伊州芝加哥）分析数据。组间比较采用t检验和卡方检验。重复测量检验用于比较两组的血糖。Mann-Whitney U检验用于比较机械通气时间和ICU住院时间。统计学显著性定义为P值<0.05。
主要和次要结局指标之间无显著差异。关于晚期结局，对照组（7例患者）的胸骨伤口感染多于干预组（1例患者）（P<0.05）。两组其他并发症之间未观察到差异。两组低血糖的发生率均较低。干预组低钾血症显著高于对照组（P<0.001）。
研究结果表明，在心脏手术期间将血糖调整为严格控制至接近正常水平可能会减少低血糖发作，从而降低其副作用。同时减少高血糖并发症，如胸骨伤口感染。
IRCT2013041713052N1）。2013年7月9日。
