naa a22 4500 510728707 CHVBK 20180411082944.0 cr unu---uuuuu 180411e20130201xx s 000 0 eng 10.1007/s11748-012-0198-9 doi (NATIONALLICENCE)springer-10.1007/s11748-012-0198-9 Perioperative control of blood glucose level in cardiac surgery [Elektronische Daten] [Kenji Minakata, Ryuzo Sakata] It is well recognized that poor perioperative blood glucose (BG) control can increase the risk of infection, cardiovascular accidents, and even death in patients undergoing cardiac surgery. Since it has been reported that tight BG control (80-110mg/dL) yields better outcomes in critically ill patients, it became a standard of care to control BG using intravenous insulin infusion in ICU. However, it has been debated in terms of the optimal target range whether a strict control with intensive insulin therapy is better than liberal control. Because strict BG control can often cause hypoglycemia, which in turn increases the hospital mortality. In fact, a meta-analysis of randomized clinical trials concluded that tight BG control was not associated with significantly reduced hospital mortality but was associated with an increased risk of hypoglycemia. According to the current published guidelines, it seems to be optimal to control BG level of 140-180mg/dL in ICU. In terms of more strict BG control (110-140mg/dL), it may be appropriate in selected patients as long as this can be achieved without significant hypoglycemia. The Japanese Association for Thoracic Surgery, 2012 Blood glucose level nationallicence Cardiac surgery nationallicence Diabetes mellitus nationallicence Infection nationallicence Mortality nationallicence Minakata Kenji Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan aut Sakata Ryuzo Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan aut General Thoracic and Cardiovascular Surgery Springer Japan 61/2(2013-02-01), 61-66 1863-6705 61:2<61 2013 61 11748 https://doi.org/10.1007/s11748-012-0198-9 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11748-012-0198-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Minakata Kenji Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan aut NATIONALLICENCE 700 1- Sakata Ryuzo Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan aut NATIONALLICENCE 773 0- General Thoracic and Cardiovascular Surgery Springer Japan 61/2(2013-02-01), 61-66 1863-6705 61:2<61 2013 61 11748 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer