Intensive Intraoperative Insulin Therapy versus Conventional Glucose Management during Cardiac Surgery

Abstract

Letters2 October 2007Intensive Intraoperative Insulin Therapy versus Conventional Glucose Management during Cardiac SurgeryGunjan Y. Gandhi, MD, MSc, Gregory A. Nuttall, MD, and Martin D. Abel, MDGunjan Y. Gandhi, MD, MScFrom the Mayo Clinic College of Medicine, Rochester, MN 55905.Search for more papers by this author, Gregory A. Nuttall, MDFrom the Mayo Clinic College of Medicine, Rochester, MN 55905.Search for more papers by this author, and Martin D. Abel, MDFrom the Mayo Clinic College of Medicine, Rochester, MN 55905.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-7-200710020-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Carvalho and Schricker ask for several details on the surgical interventions pertaining to the applicability of study findings to other settings rather than to the validity of results. It is important to realize that the degree of intraoperative glycemic control was the only difference in study intervention between the 2 groups. The beauty of randomization with allocation concealment is that all known and unknown prognostic variables should be equally distributed between the 2 study groups. Specific surgical details can be provided by personal communication but are beyond the scope of our response.Although we appreciate the concerns ...References1. van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, et al. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001;345:1359-67. [PMID: 11794168] CrossrefMedlineGoogle Scholar2. Lazar HL, Chipkin SR, Fitzgerald CA, Bao Y, Cabral H, Apstein CS. Tight glycemic control in diabetic coronary artery bypass graft patients improves perioperative outcomes and decreases recurrent ischemic events. Circulation. 2004;109:1497-502. [PMID: 15006999] CrossrefMedlineGoogle Scholar3. Bucerius J, Gummert JF, Borger MA, Walther T, Doll N, Onnasch JF, et al. Stroke after cardiac surgery: a risk factor analysis of 16, 184 consecutive adult patients. Ann Thorac Surg. 2003;75:472-8. [PMID: 12607656] CrossrefMedlineGoogle Scholar4. Gandhi GY, Nuttall GA, Abel MD, Mullany CJ, Schaff HV, Williams BA, et al. Intraoperative hyperglycemia and perioperative outcomes in cardiac surgery patients. Mayo Clin Proc. 2005;80:862-6. [PMID: 16007890] CrossrefMedlineGoogle Scholar5. Carvalho G, Moore A, Qizilbash B, Lachapelle K, Schricker T. Maintenance of normoglycemia during cardiac surgery. Anesth Analg. 2004;99:319-24, table of contents. [PMID: 15271698] Google Scholar Author, Article, and Disclosure InformationAffiliations: From the Mayo Clinic College of Medicine, Rochester, MN 55905. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIntensive Intraoperative Insulin Therapy versus Conventional Glucose Management during Cardiac Surgery Gunjan Y. Gandhi , Gregory A. Nuttall , Martin D. Abel , Charles J. Mullany , Hartzell V. Schaff , Peter C. O'Brien , Matthew G. Johnson , Arthur R. Williams , Susanne M. Cutshall , Lisa M. Mundy , Robert A. Rizza , and M. Molly McMahon Intensive Intraoperative Insulin Therapy versus Conventional Glucose Management during Cardiac Surgery George Carvalho and Thomas Schricker Intensive Intraoperative Insulin Therapy versus Conventional Glucose Management during Cardiac Surgery Ragheb Assaly and Robert H. Habib Intensive Intraoperative Insulin Therapy versus Conventional Glucose Management during Cardiac Surgery Ferran Rius and Didac Mauricio Metrics 2 October 2007Volume 147, Issue 7Page: 522KeywordsAttentionCardiac surgeryGlucoseHypoglycemiaHypoglycemicsInsulinLongitudinal studiesReproducibilityStrokeVentilators ePublished: 2 October 2007 Issue Published: 2 October 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...