• Clinical Evidence

A Randomized Study in Diabetic Patients Undergoing Cardiac Surgery Comparing Computer-Guided Glucose Management With a Standard Sliding Scale Protocol

Setting: 1425-bed teaching hospital and Level 1 trauma center.

Objective

This prospective, randomized trial compares use of a paper protocol to a computer-guided glucose management system (EndoTool) for cardiac surgery patients receiving intravenous insulin.

Setting

1425-bed teaching hospital and Level 1 trauma center.

Results

  • Percentage of blood glucoses in the desired range of 90-150 mg/dL was 81.5% higher with EndoTool during the intra-operative phase (49% vs 27%) and 40% higher during the post-operative ICU phase (84% vs 60%).
  • Time in the desired range was 89% higher with EndoTool during the intra-operative phase (121 vs 64 minutes) and 42.2% higher during the post-operative ICU phase (536 vs 377 minutes).
  • Time to a target blood glucose <150 mg/dL was 31.9% lower with EndoTool during the intra-operative phase (62 vs 91 minutes) and 76% lower during the post-operative ICU phase (40 vs 171 minutes).
  • Overall mean average blood glucose was 30 mg/dL lower with EndoTool during the intra-operative phase (147 vs 177 mg/dL) and 21 mg/dL lower during the post-operative ICU phase (126 vs 147 mg/dL).

Conclusions

A computer-guided glucose management system (EndoTool) achieves effective and safe blood glucose control in the ICU population both during and after cardiac surgery, and more rapid and tighter glucose control than a paper protocol.

Objective

This prospective, randomized trial compares use of a paper protocol to a computer-guided glucose management system (EndoTool) for cardiac surgery patients receiving intravenous insulin.

Setting

1425-bed teaching hospital and Level 1 trauma center.

Results
  • Percentage of blood glucoses in the desired range of 90-150 mg/dL was 81.5% higher with EndoTool during the intra-operative phase (49% vs 27%) and 40% higher during the post-operative ICU phase (84% vs 60%).
  • Time in the desired range was 89% higher with EndoTool during the intra-operative phase (121 vs 64 minutes) and 42.2% higher during the post-operative ICU phase (536 vs 377 minutes).
  • Time to a target blood glucose <150 mg/dL was 31.9% lower with EndoTool during the intra-operative phase (62 vs 91 minutes) and 76% lower during the post-operative ICU phase (40 vs 171 minutes).
  • Overall mean average blood glucose was 30 mg/dL lower with EndoTool during the intra-operative phase (147 vs 177 mg/dL) and 21 mg/dL lower during the post-operative ICU phase (126 vs 147 mg/dL).
Conclusions

A computer-guided glucose management system (EndoTool) achieves effective and safe blood glucose control in the ICU population both during and after cardiac surgery, and more rapid and tighter glucose control than a paper protocol.

References

Authors

Leif Saager, MD; Gordon Collins, MD; Beth Burnside, BA; Heidi Tymkew, MHS; Lini Zhang, MD; Eric Jacobsohn, MBChB, MHPE, FRCPC; Michael Avidan, MBBCh, FCA.

Source

Published in Journal of Cardiothoracic and Vascular Anesthesia, Volume 22, Issue 3, p377-382.

Year

2008

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Objective
Setting
Results
Conclusions
References
Objective

This prospective, randomized trial compares use of a paper protocol to a computer-guided glucose management system (EndoTool) for cardiac surgery patients receiving intravenous insulin.

Setting

1425-bed teaching hospital and Level 1 trauma center.

Results
  • Percentage of blood glucoses in the desired range of 90-150 mg/dL was 81.5% higher with EndoTool during the intra-operative phase (49% vs 27%) and 40% higher during the post-operative ICU phase (84% vs 60%).
  • Time in the desired range was 89% higher with EndoTool during the intra-operative phase (121 vs 64 minutes) and 42.2% higher during the post-operative ICU phase (536 vs 377 minutes).
  • Time to a target blood glucose <150 mg/dL was 31.9% lower with EndoTool during the intra-operative phase (62 vs 91 minutes) and 76% lower during the post-operative ICU phase (40 vs 171 minutes).
  • Overall mean average blood glucose was 30 mg/dL lower with EndoTool during the intra-operative phase (147 vs 177 mg/dL) and 21 mg/dL lower during the post-operative ICU phase (126 vs 147 mg/dL).
Conclusions

A computer-guided glucose management system (EndoTool) achieves effective and safe blood glucose control in the ICU population both during and after cardiac surgery, and more rapid and tighter glucose control than a paper protocol.

References

Authors

Leif Saager, MD; Gordon Collins, MD; Beth Burnside, BA; Heidi Tymkew, MHS; Lini Zhang, MD; Eric Jacobsohn, MBChB, MHPE, FRCPC; Michael Avidan, MBBCh, FCA.

Source

Published in Journal of Cardiothoracic and Vascular Anesthesia, Volume 22, Issue 3, p377-382.

Year

2008

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