Objective: To systematically review the literature to determine the effects of intensive versus normal glycaemic control during peri-operative period on prognosis of patients undergoing cardiac surgery.
Methods: The literature was systematically reviewed based on searching criteria established by Cochrane Collaboration. PubMed database searching was conducted for literature and the language was limited to English. Each paper was reviewed by 2 independent reviewers and data extracted for statistical analysis. Data from identified studies were collected for Meta-analysis (RevMan 5.0).
Results: Seven randomized controlled trials (RCTs), involving a total of 2329 patients, were identified in the literature. The results showed that intensive glycaemic control could reduce the incidence of infection [odds ratio (OR) = 0.42, 95% confidence interval (95%CI) 0.25 to 0.73, P = 0.002], mortality (OR = 0.54, 95%CI 0.34 to 0.87, P = 0.01), the duration of mechanical ventilation [weighted mean difference (WMD) = -2.68, 95%CI -4.99 to -0.37, P = 0.02], and length of stay in the intensive care unit (ICU, WMD = -15.49, 95%CI -16.14 to -14.83, P < 0.000 01), and also could slightly reduce the incidence of post-surgical atrial fibrillation (OR = 0.77, 95%CI 0.60 to 1.00, P = 0.05). However, intensive glycaemic control could not reduce the use of epicardial pacing (OR = 0.32, 95%CI 0.09 to 1.05, P = 0.06).
Conclusion: Intensive blood glucose control during peri-operative period could improve the prognosis of patients undergoing cardiac surgery.