Intensive hyperglycemia control reduces postoperative infections after open heart surgery

Background:Diabetes mellitus increases the risk of infections in patients undergo- ing cardiac surgery. We hypothesized that intensive perioperative hyperglycemia control by in- travenous insulin infusion reduces postoperative infections in all patients undergoing open heart surgical procedures. Methods:Sixty diabetics patients who underwent CABG operation (Group 1) were compared with fifty-five patients who underwent other cardiac surgery (Group 2) between January 2004 and March 2005. A continuous infusion of insulin was used in all these patients. Results:There were no 30-day mortalities in either group. There was no difference in the inci- dence of infections between the two groups: in Group 1, 3 (5%) patients were diagnosed to have postoperative infection (superficial sternal wound infections in 1 (1.66%) and lung infection in 2 (3.33%) patients); postoperative infection occurred in only 2 patients (3.63%) in Group 2, 1 su- perficial sternal wound infections (1.81%) and 1 lung infection (1.81%). Conclusions:Our analysis indicates that continuous intravenous insulin infusion improves out- come and reduces postoperative infections in patients undergoing CABG as well as those un- dergoing other cardiac surgery procedures. (Heart International 2006; 2: 49-53