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REVIEW ARTICLE
Year : 2014  |  Volume : 18  |  Issue : 4  |  Page : 455-467

Medanta insulin protocols in patients undergoing cardiac surgery


1 Senior Consultant, Division of Endocrinology and Diabetes, Medanta, The Medicity, Gurgaon, Haryana, India
2 Chairman, Division of Endocrinology and Diabetes, Medanta, The Medicity, Gurgaon, Haryana, India
3 Scientist, Gida Technology Services, Bangalore, Karnataka, India
4 Chairman, Institute of Critical Care and Anaesthesiology, Medanta, The Medicity, Gurgaon, Haryana, India
5 Chairman, Heart Institute-Division of Cardiothoracic and Vascular Surgery, Medanta, The Medicity, Gurgaon, Haryana, India

Correspondence Address:
Dr. Beena Bansal
Division of Endocrinology and Diabetes, Medanta, The Medicity, Gurgaon - 122 001, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.137486

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Hyperglycemia is common in patients undergoing cardiac surgery and is associated with poor outcomes. This is a review of the perioperative insulin protocol being used at Medanta, the Medicity, which has a large volume cardiac surgery setup. Preoperatively, patients are usually continued on their preoperative outpatient medications. Intravenous insulin infusion is intiated postoperatively and titrated using a column method with a choice of 7 scales. Insulin dose is calculated as a factor of blood glucose and patient's estimated insulin sensitivity. A comparison of this protocol is presented with other commonly used protocols. Since arterial blood gas analysis is done every 4 hours for first two days after cardiac surgery, automatic data collection from blood gas analyzer to a central database enables collection of glucose data and generating glucometrics. Data auditing has helped in improving performance through protocol modification.


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