4 155

Cited 13 times in

Impact of intraoperative hyperglycaemia on renal dysfunction after off-pump coronary artery bypass

Authors
 Jong Wook Song  ;  Jae Kwang Shim  ;  Kyung Jong Yoo  ;  Se Young Oh  ;  Young Lan Kwak 
Citation
 Interactive Cardiovascular and Thoracic Surgery, Vol.17(3) : 473-478, 2013 
Journal Title
 Interactive Cardiovascular and Thoracic Surgery 
ISSN
 1569-9293 
Issue Date
2013
Abstract
OBJECTIVES: Acute kidney injury (AKI) is one of the most frequently occurring complications after off-pump coronary artery bypass graft (OPCAB). Hyperglycaemia is a major, potentially modifiable risk factor of adverse outcome after cardiac surgery known to aggravate organ damage. The aim of this study was to address the association between intraoperative glucose concentration and postoperative AKI in patients who underwent OPCAB. METHODS: The medical records of 880 consecutive patients were retrospectively reviewed. Patients were divided into three groups according to the time-weighted average of intraoperative glucose concentrations (<110, 110-150 and >150 mg/dl), and the incidence of AKI (increase of serum creatinine to >2.0 mg/dl and 2 × most recent preoperative value or a new requirement for dialysis) was compared. Multivariate logistic regression analysis was performed to identify independent risk factors for postoperative AKI. RESULTS: The incidence of AKI was higher in patients with a glucose level >150 mg/dl than in patients with a glucose level = 110-150 mg/dl [8% (20 of 251) vs 3% (14 of 453), P = 0.004]. On multivariate analysis, glucose >150 mg/dl (odds ratio [OR], 2.78; 95% confidence interval [CI], 1.12-6.86, P = 0.027), coefficient of variation of glucose (OR, 1.04; 95% CI, 1.01-1.07, P = 0.027) and preoperative serum creatinine >1.4 mg/dl (OR, 8.81; 95% CI, 3.90-19.9, P < 0.001) were identified as independent risk factors for postoperative AKI. CONCLUSIONS: Intraoperative glucose concentration >150 mg/dl and increased variability of glucose were independently associated with AKI after OPCAB. Tight intraoperative glycaemic control (<110 mg/dl) does not seem to provide additional benefit in terms of AKI.
Full Text
http://icvts.oxfordjournals.org/content/17/3/473.long
DOI
10.1093/icvts/ivt209
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실)
Yonsei Authors
곽영란(Kwak, Young Lan) ORCID logo https://orcid.org/0000-0002-2984-9927
송종욱(Song, Jong Wook) ORCID logo https://orcid.org/0000-0001-7518-2070
심재광(Shim, Jae Kwang) ORCID logo https://orcid.org/0000-0001-9093-9692
오세영(Oh, Se Young)
유경종(Yoo, Kyung Jong) ORCID logo https://orcid.org/0000-0002-9858-140X
Export
RIS (EndNote)
XLS (Excel)
XML
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87511
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse