Intraoperative tight blood glucose control reduces the incidence of postoperative pneumonia in minimally invasive esophagectomy: a randomized clinical trial
Abstract
BACKGROUND
Postoperative pneumonia is a common and fatal complication in minimally invasive esophagectomy patients and is related to perioperative blood glucose. This study hypothesized that compared to dealing with intraoperative blood glucose routinely, tight blood glucose control can reduce the incidence of postoperative pneumonia in minimally invasive esophagectomy patients.
METHODS
In this randomized single- blind trial, 88 patients were randomly assigned (1:1) to the tight blood glucose control (4.4-6.1 mmol/L) or non-tight blood glucose control (blood glucose under 10 mmol/L). The primary outcome was the incidence of postoperative pneumonia. The intraoperative insulin-related complications, postoperative inflammation level, blood glucose level, surgical complications, and other secondary outcomes were also assessed.
RESULTS
In total, 88 patients were randomized, and 84 patients were included in the analysis. The intention-to-treat analysis showed the incidence of postoperative pneumonia in the tight blood glucose control group (5 of 44 [11.4%]) was significantly lower than non-tight blood glucose control group (15 of 44 [34.1%]) (OR = 0.569, 95% CI: 0.39 to 0.83, P = 0.011). The C-reactive protein on postoperative day 1 was 78.3 (30.4-103.7) in the tight blood glucose control group and 95.6 (79.0-130.5) in the non-tight blood glucose control group (P = 0.008). Compared to the non-tight blood glucose control group (36 of 43 [83.7%]), the demand for advanced antibiotics…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 88 participants or records.
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