• Takeshiro Fujii, Yoshinori Watanabe, Noritsugu Shiono, Muneyasu Kawasaki, Hiroki Yokomuro, Tsukasa Ozawa, Satoshi Hamada, Hiroshi Masuhara, and Nobuya Koyama.
• Toho University School of Medicine, Department of Surgery, Division of Cardiovascular Surgery, 6-11-1 Omorinishi, Ota-ku, Tokyo 143-8541, Japan. fujiit@aol.com
• Gen Thorac Cardiovasc Surg. 2007 Oct 1;55(10):409-15.

ObjectiveWe investigated the usefulness of perioperative blood glucose control in patients undergoing coronary artery bypass grafting (CABG).MethodsDM patients were aggressively treated with intensive insulin therapy to achieve a preoperative fasting blood glucose level of 140 mg/dl and a postoperative level of 200 mg/dl. For comparison, patients were divided as follows: (1) DM group vs. non-DM group, and (2) for mean blood glucose level in the intensive care unit (ICU), lower than 200 mg/dl (IL) vs. 200 mg/dl or higher (IH).Results(1) In the DM group, the amount of insulin (U) used during surgery was greater (P<0.05), and the duration of ICU stay was longer (P<0.05). The incidence of all complications was higher in the DM group (P<0.05). (2) Between the IH group (54) and the IL group (82), the proportion of DM patients was higher in the IH group (75% vs. 38%, P<0.05). In the IH, the duration of ICU stay (P<0.01) was longer, and the incidence of all complications was higher (P<0.05). (3) In the DM group, the incidence of complications tended to be higher in the IH group. The incidence of complications was extremely low in the non-DM group.ConclusionStrict perioperative blood glucose control may help to improve the outcomes of CABG.

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