The effectiveness of tight glycemic control on decreasing surgical site infections and readmission rates in adult patients with diabetes undergoing cardiac surgery: A systematic review.
Boreland, Lyn MSN, RN, FNP-BC, DNPc; Scott-Hudson, Marcia MSN, RN, FNP-BC, DNPc; Hetherington, Kathy MSN, RN, FNP-BC, DNPc; Frussinetty, Antoinette MSN, RN, FNP-BC, DNPc; Slyer, Jason T. DNP, RN, FNP-BC, CHFN *
[Miscellaneous Article]
Heart & Lung: Journal of Acute & Critical Care.
44(5):430-440, September 2015.
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Objective: A systematic review of the effects of tight glycemic control with a continuous insulin infusion to achieve blood glucose levels <= 200 mg/dL on surgical site infections and readmission rates in adult patients with diabetes after cardiac surgery.
Methods: A quantitative systematic review of the literature. Databases, including PubMed, CINAHL, EMBASE, and CENTRAL, were searched for relevant studies from database inception through August 2014. Randomized and quasi-experimental studies were included.
Results: A meta-analysis of ten studies demonstrated that glycemic control with a continuous insulin infusion to achieve blood glucose levels <= 200 mg/dL significantly reduced surgical site infection rates (odds ratio 0.35, 95% confidence interval 0.25-0.49; Z = 6.0, P < 0.00001) compared with standard diabetes management.
Conclusions: Maintaining blood glucose levels <= 200 mg/dL with a continuous insulin infusion in all stages of the perioperative period in cardiac surgery patients with diabetes can reduce the incidence of surgical site infections.
(C) 2015Elsevier, Inc.