Comparing Glycemic Control Methods in Open-Heart Surgery

Noting the need for less laborious glucose control methods during open-heart surgery—particularly in diabetic patients at higher risk of developing complications—co-lead researchers, Roland Kaddoum and Amro Khalili, and colleagues evaluated an automated glucose control system. They found that the automated glucose pump effectively kept diabetic patients within predefined glucose ranges during surgery. The study was published in BMC Anesthesiology.

The researchers enrolled patients aged 40 to 75 years and randomized them to receive either the experimental automated system or the conventional technique. According to the article, the researchers observed that the proportion of patients maintained between 7.8 and 10 mmol.l^-1 was not statistically different between the two groups.

However, they noted that 14 (26.7%) patients in the experimental group maintained glucose levels within a safety range of 6.7-10 mmol.l^-1, significantly higher than the 5 (17.2%) patients in the control group who did (P=.025).

Additionally, 17 (58.6%) patients in the control group experienced at least one intraoperative hyperglycemic event compared to 5 (17.2%) in the experimental group (P<.001), and 2 patients in the control group experienced hypoglycemic events compared to 0 in the experimental group. The study’s authors also noted that longer surgeries appeared to benefit more from the automated glucose pump system, particularly surgeries lasting more than 210 minutes.

Overall, the authors determined that the automated glucose control system kept most diabetic patients undergoing open-heart surgery within a predefined perioperative glucose range, with very low rates of hyper- and hypoglycemia. They proposed that this method “is less laborious in terms of interventions by the anesthesiologist.”