RESUMO
OBJECTIVE: A systematic review of the effects of tight glycemic control with a continuous insulin infusion to achieve blood glucose levels ≤ 200 mg/dL on surgical site infections and readmission rates in adult patients with diabetes after cardiac surgery. METHODS: A quantitative systematic review of the literature. Databases, including PubMed, CINAHL, EMBASE, and CENTRAL, were searched for relevant studies from database inception through August 2014. Randomized and quasi-experimental studies were included. RESULTS: A meta-analysis of ten studies demonstrated that glycemic control with a continuous insulin infusion to achieve blood glucose levels ≤ 200 mg/dL significantly reduced surgical site infection rates (odds ratio 0.35, 95% confidence interval 0.25-0.49; Z = 6.0, P < 0.00001) compared with standard diabetes management. CONCLUSIONS: Maintaining blood glucose levels ≤ 200 mg/dL with a continuous insulin infusion in all stages of the perioperative period in cardiac surgery patients with diabetes can reduce the incidence of surgical site infections.
