Abstract

BENZADON, Mariano N. et al. Usefulness of a Computer-Assisted Protocol for Strict Glycemic Control in Patients Submitted to Cardiac Surgery. Rev. argent. cardiol. [online]. 2008, vol.76, n.5, pp.368-374. ISSN 1850-3748.

The outcomes of patients improve with a strict glycemic control during the postoperative period of cardiovascular surgery; however, written protocols may fail to achieve a tight control of glycemia. Objective To determine the usefulness of a computer-assisted protocol for strict glycemic control in order to increase the adherence of health care providers to current recommendations and to improve the glycemic control in patients submitted to cardiovascular surgery. Material and Methods Patients were divided into two groups. Control group included 118 consecutive patients who underwent coronary artery bypass graft surgery during the last quarter of 2005; strict glycemic control was managed with a written protocol. Treatment group consisted of 117 consecutive patients operated on during the last quarter of 2006; in this group of patients glycemic control was managed with a computerassisted protocol. Both protocols were identical. Results As protocols for strict glycemic control recommend, the first glycemia was determined earlier in the treatment group versus the control group (60 IQR 40-65 versus 150 IQR 60- 270 min; p<0,001) and blood glucose levels were measured more times (18±6.6 versus 11±6.4; p<0,0001). The percentage of determinations with normoglycemia was greater among patients in the treatment group (67%±18% versus 50%±25%; p<0.0001) and the time interval to normoglycemia was lower (165 IQR 105-280 versus 420 IQR 295-720 min; p<0,001). Conclusion A computer-assisted protocol is useful to increase the adherence of health care providers to current recommendations and to improve the glycemic control in patients submitted to cardiovascular surgery.

Keywords : Coronary Arteries; Hyperglycemia; Thoracic Surgery Procedures.

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