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Blood Glucose Control in Post-Coronary Artery Bypass Graft (CABG) Patients
Friday April 25, 2025 11:20am - 11:35am EDT
Parthenon 1
Title: Blood Glucose Control in Post-Coronary Artery Bypass Graft (CABG) Patients


Authors: Elise M. Richoux, Leslie A. Hamilton, Heather Wallhauser, Rachael Samples, Taylor Bird, Robert E. Heidel, Travis Fleming


Objective: The objective of this study was to evaluate the median of time within goal blood glucose range following CABG surgery while receiving a continuous insulin infusion in groups before and after an insulin protocol change.


Presentation Objective: Evaluate the impact and incidence of goal blood glucose attainment in patients post-CABG on a continuous insulin infusion before and after an insulin protocol change.


Self Assessment Question: Which statement best describes the impact of hyperglycemia during and after cardiac surgery?
 
Background: Hyperglycemia following cardiac procedures is common. This is likely due to surgical stress triggering catecholamine and cortisol release, along with intraoperative hypothermia induced during cardiopulmonary bypass, which stimulates sympathetic activity. Elevated blood glucose levels during the intra-operative and post-operative period of cardiac surgery is associated with an increased risk of mortality in patients with and without diabetes as well as prolonged ventilator times, atrial fibrillation, and delirium. Controlling blood glucose levels can mitigate consequences such as prolonged ventilation, delayed sternal wound healing, and risk of mortality in patients with and without diabetes. Existing literature has inconsistency in blood glucose targets relative to observed outcomes, prompting consideration of the optimal level of glycemic control for post-CABG patients. More recently, the Society of Thoracic Surgeons (STS) published consensus statements on perioperative cardiac care which included a goal blood glucose range of 140-180mg/dL once an insulin infusion is initated. A protocol change implemented in August 2023 for cardiothoracic surgery patients replaced the previous insulin drip titration method, based on a multiplier and a blood glucose goal of 110-139 mg
Moderators
avatar for Matt Conley

Matt Conley

Pharmacy Informatics Specialist, AdventHealth
Presenters
ER

Elise Richoux

PGY-1 Pharmacy Resident, University of Tennessee Medical Center
Dr. Richoux grew up in Luling, Louisiana. She completed her pre-pharmacy education at the University of Louisiana at Lafayette and attended Samford University McWhorter School of Pharmacy where she received a Bachelor of Science in Pharmacy Studies and a Doctor of Pharmacy degree... Read More →
Evaluators
EM
Friday April 25, 2025 11:20am - 11:35am EDT
Parthenon 1
  Internal Medicine (IM), University of Tennessee Medical Center
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