SynthesisJournal of cardiothoracic surgery2011
The effect of tight glycaemic control, during and after cardiac surgery, on patient mortality and morbidity: A systematic review and meta-analysis.
Synthesis in Journal of cardiothoracic surgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The connotation between perioperative glycemic control approach and sternal wound infection in individuals with diabetes mellitus experiencing cardiac surgery: A meta-analysis.International wound journal · 2023Pooled it
- Association Between Perioperative Glycemic Control Strategy and Mortality in Patients With Diabetes Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis.Frontiers in endocrinology · 2020Pooled it
- Can dexmedetomidine be a safe and efficacious sedative agent in post-cardiac surgery patients? a meta-analysis.Critical care (London, England) · 2012Pooled it
- Impact of intensive glycemic control on the incidence of atrial fibrillation and associated cardiovascular outcomes in patients with type 2 diabetes mellitus (from the Action to Control Cardiovascular Risk in Diabetes Study).The American journal of cardiology · 2014Trial
- Intraoperative maintenance of normoglycemia with insulin and glucose preserves verbal learning after cardiac surgery.PloS one · 2014Trial
- Evaluation of a continuous blood glucose monitoring system using central venous microdialysis.Journal of diabetes science and technology · 2012Trial
- Glycated Haemoglobin (HbAJournal of clinical medicine · 2024Review
- Insulin mitigates acute ischemia-induced atrial fibrillation and sinoatrial node dysfunction ex vivo.JCI insight · 2024Article
- [Position statement: surgery and diabetes mellitus (Update 2023)].Wiener klinische Wochenschrift · 2023Article
- Is postoperative cognitive decline after cardiac surgery associated with plasma beta amyloid 1-42 levels?Journal of cardiothoracic surgery · 2022Article
- Article
- Effect of Preablation Glycemic Control on Outcomes of Atrial Fibrillation Patients With Diabetes Mellitus Following Valvular Surgery Combined With the Cox-Maze IV Procedure.Frontiers in cardiovascular medicine · 2022Article
- Glycemic Control in Coronary Artery Bypass Graft Surgery: A Different Perspective.Anesthesiology and pain medicine · 2021Article
- Prevention, Diagnosis and Management of Post-Surgical Mediastinitis in Adults Consensus Guidelines of the Spanish Society of Cardiovascular Infections (Journal of clinical medicine · 2021Review
- 2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery.Interactive cardiovascular and thoracic surgery · 2020Article
- [Position statement: surgery and diabetes mellitus (Update 2019)].Wiener klinische Wochenschrift · 2019Review
- MySurgeryRisk: Development and Validation of a Machine-learning Risk Algorithm for Major Complications and Death After Surgery.Annals of surgery · 2019Article
- Effects of perioperative tight glycemic control on postoperative outcomes: a meta-analysis.Endocrine connections · 2018Review
- Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation.Diabetes, metabolic syndrome and obesity : targets and therapy · 2017Article
- [Position statement: surgery and diabetes mellitus].Wiener klinische Wochenschrift · 2016Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHyperglycaemia is a common occurrence during cardiac surgery, however, there remains some uncertainty surrounding the role of tight glycaemic control (blood glucose <180 mg/dL) during and/or after surgery. The aim of this study was to systematically review the literature to determine the effects of tight versus normal glycaemic control, during and after cardiac surgery, on measures of morbidity and mortality.
methodThe literature was systematically reviewed, based on pre-determined search criteria, for clinical trials evaluating the effect of tight versus normal glycaemic control during and/or after cardiac surgery. Each paper was reviewed by two, independent reviewers and data extracted for statistical analysis. Data from identified studies was combined using meta-analysis (RevMan5®). The results are presented either as odds ratios (OR) or mean differences (MD) with 95% confidence intervals (CIs).
resultsA total of seven randomised controlled trials (RCTs) were identified in the literature, although not all trials could be used in each analysis. Tight glycaemic control reduced the incidence of early mortality (death in ICU) (OR 0.52 [95% CI 0.30, 0.91]); of post-surgical atrial fibrillation (odds ratio (OR 0.76 [95%CI 0.58, 0.99]); the use of epicardial pacing (OR 0.28 [95%CI 0.15, 0.54]); the duration of mechanical ventilation (mean difference (MD) -3.69 [95% CI -3.85, -3.54]) and length of stay in the intensive care unit (ICU) (MD -0.57 [95%CI -0.60, -0.55]) days. Measures of the time spent on mechanical ventilation (I2 94%) and time spent in ICU (I2 99%) both had high degrees of heterogeneity in the data.
conclusionThe results from this study suggest that there may be some benefit to tight glycaemic control during and after cardiac surgery. However, due to the limited number of studies available and the significant variability in glucose levels; period of control; and the reporting of outcome measures, further research needs to be done to provide a definitive answer on the benefits of tight glycaemic control for cardiac surgery patients.
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Registered trials
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