A piece of research conducted by Heart Hospital, a member of Hamad Medical Corporation (HMC), is one of the most highly accessed research articles on the website of BMC Anaesthesiology, an open access, peer-reviewed journal. The research entitled ‘Association of Time in Blood Glucose Range with Outcomes Following Cardiac Surgery’ is currently in the top 25% of all research outputs scored by Altmetric, which measures the attention that a scholarly article has received from various sources.
The research work, which was published on the website in January 2015, recently won the Research Award at HMC’s Annual Stars of Excellence Awards ceremony.
Dr Amr Salah Omar, Cardiovascular Intensive Care Unit Consultant at Heart Hospital and head of the research team explained that both diabetic and non-diabetic patients who are admitted to the intensive care unit (ICU) are often at risk of high blood glucose levels as a result of the tension they experience, increased levels of some hormones, and infections associated with being in intensive care as well as those caused by exposure to an artificial heart device.
A high level of blood glucose could delay discharge from the ICU, which means that patients could be exposed to bacterial infections or severe complications, such as renal failure and atrial fibrillation, and consequently, to increased length of stay in the ICU.’
‘Global trends show us that it is important to have control over a patient’s blood sugar levels after an operation, hence at Heart Hospital we developed a protocol, in collaboration with the American Diabetes Council in Texas, to better control patient blood glucose levels.’
Dr Omar explained:
We created a way to measure what we termed as ‘time in range’ (TIR) to assess postoperative glycemic control in cardiac patients by recording time and the blood glucose range. We divided the patient cohort into two groups – the first group’s blood sugar was under control for more than 80% of the total length of their stay in intensive care, while the second group’s blood sugar was controlled less than 80 percent of their stay.’
Dr Omar continued:
After this, we compared complications and the time patients of both groups were kept on ventilators alongside their length of stay in intensive care. We came to the conclusion that patients whose blood sugar we were able to control longer, stayed less time in the intensive care, and this also meant a lower risk of complications such as infections and kidney failure along with atrial fibrillation. On the other hand, patients whose blood sugar levels were less controlled demonstrated higher glucose levels in the glycated hemoglobin (HbA1C) tests.’
‘In order to improve further, we suggested that we try to add more control measures for patients who suffer high glycated hemoglobin, by postponing their surgery until their blood sugar is brought under control in the ICU.’
He noted that the new measurement method he and his team introduced was met with great acclaim by international reviewers from the University of Colorado in the US.
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