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Heart Lung. 2015 Sep-Oct;44(5):430-40. doi: 10.1016/j.hrtlng.2015.06.004. Epub 2015 Jun 29.

The effectiveness of tight glycemic control on decreasing surgical site infections and readmission rates in adult patients with diabetes undergoing cardiac surgery: A systematic review.

Author information

1
Pace University, College of Health Professions, Lienhard School of Nursing, 163 William Street, 5th Floor, New York, NY 10038, USA.
2
Pace University, College of Health Professions, Lienhard School of Nursing, 163 William Street, 5th Floor, New York, NY 10038, USA. Electronic address: jslyer@pace.edu.

Abstract

OBJECTIVE:

A systematic review of the effects of tight glycemic control with a continuous insulin infusion to achieve blood glucose levels ≤ 200 mg/dL on surgical site infections and readmission rates in adult patients with diabetes after cardiac surgery.

METHODS:

A quantitative systematic review of the literature. Databases, including PubMed, CINAHL, EMBASE, and CENTRAL, were searched for relevant studies from database inception through August 2014. Randomized and quasi-experimental studies were included.

RESULTS:

A meta-analysis of ten studies demonstrated that glycemic control with a continuous insulin infusion to achieve blood glucose levels ≤ 200 mg/dL significantly reduced surgical site infection rates (odds ratio 0.35, 95% confidence interval 0.25-0.49; Z = 6.0, P < 0.00001) compared with standard diabetes management.

CONCLUSIONS:

Maintaining blood glucose levels ≤ 200 mg/dL with a continuous insulin infusion in all stages of the perioperative period in cardiac surgery patients with diabetes can reduce the incidence of surgical site infections.

KEYWORDS:

Cardiac surgery; Diabetes; Glycemic control; Insulin; Surgical site infection

PMID:
26138777
DOI:
10.1016/j.hrtlng.2015.06.004
[Indexed for MEDLINE]

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