treatment of post-op hyperglycemia

Specialties MICU


I'm interested in how post-op hyperglycemia is being managed. Of particular interest are cardiac surgery patients. Are you using insulin drips, sliding scales, or both? Any protocols you can clue me into? At what level of blood glucose are you starting to treat? Also, does anyone have any articles that relate hyperglycemic control to infections? All help is appreciated.

Specializes in ICU, tele.

Our fresh hearts are on Insulin gtt once their BG reaches 120. We check it every hour and adjust per policy. We call it "the obligatory insulin drip" because it seems like everyone is on it. It's a pain in the a--, but it does cut down on sternal infections and healing time.

Specializes in postpartum/rehab/med-surg.
All of our post op CABs are on insulin gtts, whether they are a diabetic or not, so we are not just talking about post op diabetics. The stress of the surgery causes even non diabetics sugars to be high. I realize the point of a sliding scale, what I am referring to is the new guidelines for "normal" blood sugar range may not be well tolerated by poorly controlled diabetics who are not used to their blood sugars running so low. Some may be able to tolerate 80-100 range and feel okay, most probably will, but the new guidelines that say 60-90, how many do you think would tolerate that range as well? That is what I was referring to.

And yes, I know that tight blood sugar control cuts down on infection rates and improves healing time. We do have a very aggressive sliding scale to keep our blood sugars low for CABs for this very reason. If you have a big sternotomy or did a LIMA you don't want to have poor healing of the sternal wound, nor do you want less than optimal blood flow to chest region where the LIMA is if the blood sugars are too high.

Hi there,

I'm so glad you pointed out that even non-diabetics can develop hypergycemia post CABG surgery b/c my husband just underwent this

procedure, is not diabetic and unfortunately, has developed

this complication.

I am a new grad and was not aware that this could happen.

I was getting more alarmed reading about post-op complications

when a CABG pt does not have tight BS control. Your post made me

feel alot better. Thank you.

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