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Medanta insulin protocols in patients undergoing cardiac surgery.


ABSTRACT: Hyperglycemia is common in patients undergoing cardiac surgery and is associated with poor outcomes. This is a review of the perioperative insulin protocol being used at Medanta, the Medicity, which has a large volume cardiac surgery setup. Preoperatively, patients are usually continued on their preoperative outpatient medications. Intravenous insulin infusion is intiated postoperatively and titrated using a column method with a choice of 7 scales. Insulin dose is calculated as a factor of blood glucose and patient's estimated insulin sensitivity. A comparison of this protocol is presented with other commonly used protocols. Since arterial blood gas analysis is done every 4 hours for first two days after cardiac surgery, automatic data collection from blood gas analyzer to a central database enables collection of glucose data and generating glucometrics. Data auditing has helped in improving performance through protocol modification.

SUBMITTER: Bansal B 

PROVIDER: S-EPMC4138898 | biostudies-other | 2014 Jul

REPOSITORIES: biostudies-other

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Medanta insulin protocols in patients undergoing cardiac surgery.

Bansal Beena B   Mithal Ambrish A   Carvalho Pravin P   Mehta Yatin Y   Trehan Naresh N  

Indian journal of endocrinology and metabolism 20140701 4


Hyperglycemia is common in patients undergoing cardiac surgery and is associated with poor outcomes. This is a review of the perioperative insulin protocol being used at Medanta, the Medicity, which has a large volume cardiac surgery setup. Preoperatively, patients are usually continued on their preoperative outpatient medications. Intravenous insulin infusion is intiated postoperatively and titrated using a column method with a choice of 7 scales. Insulin dose is calculated as a factor of blood  ...[more]

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