Usefulness of perioperative blood glucose control in patients undergoing off-pump coronary artery bypass grafting.

We investigated the usefulness of perioperative blood glucose control in patients undergoing coronary artery bypass grafting (CABG). DM patients were aggressively treated with intensive insulin therapy to achieve a preoperative fasting blood glucose level of 140 mg/dl and a postoperative level of 200 mg/dl. For comparison, patients were divided as follows: (1) DM group vs. non-DM group, and (2) for mean blood glucose level in the intensive care unit (ICU), lower than 200 mg/dl (IL) vs. 200 mg/dl or higher (IH). (1) In the DM group, the amount of insulin (U) used during surgery was greater ( P < 0.05), and the duration of ICU stay was longer ( P < 0.05). The incidence of all complications was higher in the DM group ( P < 0.05). (2) Between the IH group (54) and the IL group (82), the proportion of DM patients was higher in the IH group (75% vs. 38%, P < 0.05). In the IH, the duration of ICU stay ( P < 0.01) was longer, and the incidence of all complications was higher ( P < 0.05). (3) In the DM group, the incidence of complications tended to be higher in the IH group. The incidence of complications was extremely low in the non-DM group. Strict perioperative blood glucose control may help to improve the outcomes of CABG. [ABSTRACT FROM AUTHOR]