Tight glycemic control versus conventional glycemic control during cardiac sur-gery with cardiopulmonary bypass：a Meta-Analysis
Zeng Qing-dong
Guo Sha-sha
Sun Yan-hua
Liu Gang
Li Yong-nan
Zhou Qin
Ji Bing-yang
Zheng Zhe
Abstract：Objective The aim of this meta-analysis is to determine the effect of tight versus conventional glycemic control during cardiac surgery with cardiopulmonary bypass ( CPB) on measures of morbidity and mortality. Methods Studies in which adult cardiac surgical patients were assigned randomly to tight glycemic control ( TGC) versus conventional glycemic control ( CGC) were searched through PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. Data extracted from identified studies were analyzed using RevMan 5.1. The results were presented as odd ratio ( OR) and standardized mean difference ( SMD) with 95%confidence intervals ( CIs) . Results Fourteen randomized controlled trials that included 2732 patients were identified, although not all trials could be used in each analysis. Tight glycemic control reduced early mortality after surgery (OR=0.62, 95%CI [0.41, 0.95], P=0.03) and the mechanical ventilation time (SMD=-0.44, 95%CI [-0.84,- 0.04], P =0.03), while it conversely increased the incidence of hypoglycemia (OR=3.78, 95%CI [1.58, 9.02] , P=0.003). Conclusion Intraoperative use of TGC may decrease ear?ly mortality and shorten the mechanical ventilation time in patients undergoing cardiac surgery with CPB, conversely increase the inci?dence of hypoglycemia compared with CGC group. Beneficial effects of TGC may be demonstrated when the appropriate glycemic targets are matched to the appropriate population.
Keywords：Cardiac surgeryCardiopulmonary bypassGlycemic
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 71-76,110 )