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Importance of Perioperative Blood Glucose Management in Cardiac Surgical Patients

Department of Anesthesiology, Mayo Clinic Jacksonville, USA

For reprint information contact: Michael J Murray, MD Tel: 1 480 301 1800 Fax: 1 480 301 2319 Email: murray.michael{at}mayo.edu, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.

Tight blood glucose control has become a therapeutic goal for anesthetic management of patients undergoing cardiovascular surgery. We discuss the evidence for a link between blood glucose levels and rates of morbidity and mortality in cardiac surgical patients in the intensive care unit. Hyperglycemia per se has been associated with higher rates of deep wound infection, neurologic, renal, and cardiac complications following surgery, as well as longer intensive care unit stay. We review the specifics of glucose management in patients undergoing cardiac surgery and hypothermic cardiopulmonary bypass, including the role that insulin may play in regulating blood glucose levels intraoperatively and the relationship between insulin and outcome.