Trial reportAnesthesiology2015
Intraoperative tight glucose control using hyperinsulinemic normoglycemia increases delirium after cardiac surgery.
Trial report in Anesthesiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Pooled it
- Interventions for preventing delirium in hospitalised non-ICU patients.The Cochrane database of systematic reviews · 2016Pooled it
- Hyperinsulinemic Normoglycemia during Cardiac Surgery Reduces a Composite of 30-day Mortality and Serious In-hospital Complications: A Randomized Clinical Trial.Anesthesiology · 2018Trial
- Perioperative Best Practices and Delirium in Patients With Cognitive Impairment.JAMA network open · 2026Observational
- Association of intraoperative dexamethasone administration with postoperative delirium and the role of hyperglycaemia: a retrospective cohort study.EClinicalMedicine · 2026Article
- Establishment and validation of a nomogram of postoperative delirium in patients undergoing cardiac surgery: a retrospective study of MIMIC-IV.BMC cardiovascular disorders · 2025Article
- The Role of Stress Hyperglycemia on Delirium Onset.Journal of clinical medicine · 2025Review
- Association between preoperative persistent hyperglycemia and postoperative delirium in geriatric hip fracture patients.BMC geriatrics · 2024Article
- Association Between Antidiabetic Drugs and Delirium: A Study Based on the Adverse Drug Event Reporting Database in Japan.Clinical drug investigation · 2024Article
- Association of blood glucose change with postoperative delirium after coronary artery bypass grafting in patients with diabetes mellitus: a study of the MIMIC-IV database.Frontiers in endocrinology · 2024Article
- Myocardial protection in cardiac surgery: a comprehensive review of current therapies and future cardioprotective strategies.Frontiers in medicine · 2024Review
- Perioperative glycaemic control for people with diabetes undergoing surgery.The Cochrane database of systematic reviews · 2023Review
- Type 2 Diabetes Mellitus with Tight Glucose Control and Poor Pre-Injury Stair Climbing Capacity May Predict Postoperative Delirium: A Secondary Analysis.Brain sciences · 2022Article
- An Update on Postoperative Cognitive Dysfunction Following Cardiac Surgery.Frontiers in psychiatry · 2022Review
- Relative Hypoglycemia is Associated with Delirium in Critically Ill Patients with Diabetes: A Cohort Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2022Article
- Hyperglycemia is associated with worse 3-year survival in older patients admitted to the intensive care unit after non-cardiac surgery:Frontiers in medicine · 2022Article
- Article
- Adjusted tight control blood glucose management in diabetic patients undergoing on pump coronary artery bypass graft. A randomized clinical trial.Journal of diabetes and metabolic disorders · 2020Article
- American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Delirium Prevention.Anesthesia and analgesia · 2020Article
- Diabetes and elevated preoperative HbA1c level as risk factors for postoperative delirium after cardiac surgery: an observational cohort study.Neuropsychiatric disease and treatment · 2019Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundPostoperative delirium is common in patients recovering from cardiac surgery. Tight glucose control has been shown to reduce mortality and morbidity. Therefore, the authors sought to determine the effect of tight intraoperative glucose control using a hyperinsulinemic-normoglycemic clamp approach on postoperative delirium in patients undergoing cardiac surgery.
methodsThe authors enrolled 198 adult patients having cardiac surgery in this randomized, double-blind, single-center trial. Patients were randomly assigned to either tight intraoperative glucose control with a hyperinsulinemic-normoglycemic clamp (target blood glucose, 80 to 110 mg/dl) or standard therapy (conventional insulin administration with blood glucose target, <150 mg/dl). Delirium was assessed using a comprehensive delirium battery. The authors considered patients to have experienced postoperative delirium when Confusion Assessment Method testing was positive at any assessment. A positive Confusion Assessment Method was defined by the presence of features 1 (acute onset and fluctuating course) and 2 (inattention) and either 3 (disorganized thinking) or 4 (altered consciousness).
resultsPatients randomized to tight glucose control were more likely to be diagnosed as being delirious than those assigned to routine glucose control (26 of 93 vs. 15 of 105; relative risk, 1.89; 95% CI, 1.06 to 3.37; P = 0.03), after adjusting for preoperative usage of calcium channel blocker and American Society of Anesthesiologist physical status. Delirium severity, among patients with delirium, was comparable with each glucose management strategy.
conclusionIntraoperative hyperinsulinemic-normoglycemia augments the risk of delirium after cardiac surgery, but not its severity.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.