Impact of Diabetes Mellitus on Early Extubation in Post-CABG Patient

Ho yan howard Chan

Cardiothoracic Surgical Department, Queen Elizabeth Hospital, Hong Kong, Hong Kong

Date, time and location: 2018.05.26 13:30, Press Hall, 2F

Abstract

Objects

Diabetic patient presents as a subgroup who has vulnerable risks to develop coronary arteriopathy requiring revascularization. There is also strong association of glycemic control and perioperative morbidity. By incorporating individual patient’s pre-operative variable, it allows potential patient to have early extubation after cardiac surgery. We aim to evaluate the impacts of diabetes mellitus on practicing early extubation in post-CABG patient in a tertiary cardiothoracic institute.

Methods

To evaluate the practice of early extubation, define as within 8 hours after arrival of intensive care unit of post-CABG, consecutive patient who has undergone CABG during June 2016 to May 2017 by a single surgeon were evaluated. Patient’s demographics, clinical data were collected via Dentrite and EPR system. The timing of extubation was compared between diabetic and non-diabetic CABG patients. Other pre-operative and intra-operative data including age, body-mass index, hypertension status, operative urgency, myocardial status, X-clamp time, total bypass time, intra-operative packed cell transfusion were analyzed.

Results

There were total 69 CABG patients ( M=61, F=8, mean age 61 ) identified in the study period. All patients were evaluated by cardiac surgeon prior extubation. The mean extubation time was 9.7 hours (range 1 to 20 hours ). The success rate of early extubation was 68.1% ( n=47 ). The success rate of early extubation was 38% ( n=18 ) for diabetic group and 62% ( n=29 ) for non-diabetic group (odds ratio 0.2897, 95% confidence interval 0.1067 to 0.8813, p< 0.0206). Of the diabetic patients, other parameters including bypass time (p=0.003) and operative urgency (p=0.016) were statistically significant

Conclusions

In this study, patients with diabetics, bypass time (>90minutes) and emergency operation are associated with a negative impact on practicing early extubation in post-CABG patient.