Evidence map›Paper›PMID 40883501›Full record

ArticleScientific reports2025

Controlling intraoperative hyperglycemia in the cardiac surgical patient using the computerized electronic insulin dose calculator.

Ahmed Zaky, Zdenek Novak, Tinsley Roberson, Brittany Hatter, David L Benz, Vardas Panayotis, Gary Boutwell, John Bode, Hayden Stewart, Jorge A Alsip and 1 more

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Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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11 authors.

Ahmed ZakyDepartment of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. azaky@uabmc.edu.
Zdenek NovakDepartment of Endovascular Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Tinsley RobersonDepartment of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Brittany HatterDepartment of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
David L BenzDepartment of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Vardas PanayotisDepartment of Surgery, Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Gary BoutwellDepartment of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
John BodeDepartment of Emergency Medicine, Kansas University Medical Center, Kansas, KS, USA.
Hayden StewartDepartment of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Jorge A AlsipDepartment of Endocrinology, University of Alabama at Birmingham, Birmingham, AL, USA.
Christy LemakDepartment of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Perioperative hyperglycemia is associated with increased morbidity and mortality. We report the findings of our quality improvement project on the use of an electronic insulin dosing calculator (EIC) to reduce intraoperative hyperglycemia in a cohort of cardiac surgical patients. A pilot and a modified EIC were sequentially implemented in adult patients undergoing cardiopulmonary bypass (CPB) procedures. Outcome measures (average blood glucose (BG) before, during and after CPB), process measures (percent EIC implementation) and balancing measures (incidence of hypoglycemia and average insulin doses utilized) were compared between baseline (no-protocol), pilot and modified EIC periods. 248, 142, and 239 patients were enrolled during the baseline, pilot and modified EIC phases, respectively. The EIC was implemented in 97% (138 out of 142 patients) during the pilot phase and in 86% of patients (206 out of 240 patients) during the modified EIC phase. Average BG levels on CPB were highest at baseline compared with pilot and modified EIC phases (mean, SD, 209 mg/dl,+/-45), vs. 189.8,+/-38 mg/dl vs. 188 mg/dl, +/-40) mg/dl, respectively, p = 0.002). Mean BG values were highest at baseline compared to pilot and modified EIC phases at end of procedure (182.4, +/-49 mg/dl, vs. 122, +/-30 mg/dl, vs.123.3, mg/dl, +/-38.3, vs., respectively, p = < 0.001) and at the ICU (164 ,+/-44.4, mg/dl, vs. 140, +/-37.9 mg/dl, vs. 143.4, +/-36 mg/dl, respectively p = < 0.001). Hypoglycemia was significantly lower during EIC phase compared with baseline (1% vs. 7%, p = 0.008). Less insulin was used during the pilot and modified EIC phases compared to baseline (15.2, +/-10.3, U vs. 15.8, +/-10.2 U, vs. 31.6 +/-20.27 U, respectively, p = 0.006). These preliminary findings suggest EIC effectiveness in reducing intraoperative hyperglycemia in patients undergoing CPB.

Indexed as

Cardiac Surgical ProceduresHyperglycemiaHypoglycemic AgentsInsulinAgedBlood GlucoseCardiopulmonary BypassFemaleHumansHypoglycemiaMaleMiddle AgedPilot ProjectsBlood GlucoseHypoglycemic AgentsInsulinCardiopulmonary bypassComputerized insulin protocolsQuality improvementStress induced hyperglycemia

Identifiers

PMID40883501
PMCPMC12397417

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