11.Outcome of Strict Peri-Operative Glycemic Control in Diabetic Patients Following Open Heart Surgery
Syed Imran-ul-hassan1, Sharyar1, Muhammad Rashid2, Maryam Liaqat1, Javairia Saleem1 and Taiba Zulfiqar1
ABSTRACT
Objective: To compare the outcome in terms of post-operative complications and early morality of strict glycemic control among diabetics having open heart surgery with control group following open heart surgery.
Study Design: Prospective Cohort Study
Place and Duration of Study: This study was conducted at the Department of Anesthesia, Punjab Institute of Cardiology, Lahore from November 2020 to April 2021.
Materials and Methods: In this study, 60 patients were randomly assigned to two groups (30 patients in each group) according to a computer-generated allocation table. All the diabetic patients of 18 years to 60 years old with ASA II and III planned for cardiac surgery during this study period was included. In the control group no insulin was given to the patient unless blood glucose level exceeded 180 mg/dl. While in the study group glucose level between 80 and 110 mg/dl was targeted using continuous infusion of insulin in saline. Cardiac, Pulmonary, Renal and Neurological problems were noted. Early mortality was also documented.
Results: Mean duration of diabetes in the strict control of diabetes group was 13.57+6.32 years and in conventional group it was 12.89+5.88 years. Complications or poor outcome due to occurrence of complications or early mortality was seen in 29 patients in the conventional glycemic control group while only 8 patients in the strict glycemic control group. Cardiac complications were three times less in the tight control group. Early mortality was observed in the control group in 2 patients as compared to none in the strict / tight control group, difference was statistically significant p value <0.0001.
Conclusion: Intra-operative tight glycemic control can help in controlling post-operative morbidity after open heart surgery. With control of post-operative complications, the recovery process can be improved. All types of complications are decreased with strict glycemic control.
Key Words: Peri-Operative, Glycemic Control, Diabetic Patients, Open Heart Surgery
Citation of article: Hassan SI, Sharyar, Rashid M, Liaqat M, Saleem J, Zulfiqar T. Outcome of Strict
Peri-Operative Glycemic Control in Diabetic Patients Following Open Heart Surgery. Med Forum 2021;32(7):43-47.