Cardiac surgery patients often experience elevated blood glucose levels, which can lead to poor surgical outcomes and increased postoperative complications. Therefore, tight blood glucose control during surgery is important. Currently, there is no consensus on the best method for blood glucose control during cardiac surgery. This proposal aims to perform a randomized controlled trial to compare blood glucose control intraoperatively using an insulin drip versus insulin boluses. The primary objective of the study is to compare blood glucose control intraoperatively between patients who receive insulin drip and patients who receive insulin boluses during adult cardiac surgery. This study will be a randomized controlled trial in which adult patients undergoing cardiac surgery will be randomized into two groups: insulin drip and insulin boluses. Patients with a history of diabetes or those currently taking antidiabetic medications will be included in the study. This randomized controlled trial will provide valuable information on the optimal method for achieving blood glucose control intraoperatively. The results of this study may help improve patient outcomes and reduce the incidence of postoperative complications.
All adult patients (above 18 y of age undergoing Cardiac surgery with preoperative blood glucose level (80 -180 mg/dL)
Patient with History of diabetes and those taking antidiabetics medications.
Patients with known allergy or insulin intolerance.
Patients with severe hepatic Dysfunction.
Patient with History of hypoglycemic events in the past 6 month prior to surgery.
Parallel
Insulin Drip Therapy
DrugSimple randomization will be used for randomization. The participants will be randomized into two groups based on methods of insulin delivery. * Group A: Insulin drip will be administered at a starting rate of 2 units/hour and titrated to maintain blood glucose levels between 80-180 mg/dL. * Group B: Insulin boluses will be administered every 30 minutes to maintain blood glucose levels between 80-180 mg/dL. Insulin boluses will be considered as a control group.
Insulin boluses
DrugInsulin boluses will be administered every 30 minutes to maintain blood glucose levels between 80-180 mg/dL. Insulin boluses will be considered as a control group
Rate of severe hypoglycemia
Duration of ICU stay
The incidence of wound infection
lactate clearance
the percentage decrease in blood lactate concentration
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