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Use of Cardiopulmonary Bypass in Patients Undergoing
CABG
COR LOE
Recommendations
2a B-R 1. In patients with significant calcification of the aorta, the use of
techniques to avoid aortic manipulation (off-pump techniques
or beating heart) is reasonable to decrease the incidence of
perioperative stroke when performed by experienced surgeons.
2b B-R 2. In patients with significant pulmonary disease, off-pump
surgery may be reasonable to reduce perioperative risk when
performed by experienced surgeons.
Insulin Infusion and Other Measures to Reduce Sternal
Wound Infection in Patients Undergoing CABG
COR LOE
Recommendations
1 B-R 1. In patients undergoing CABG, an intraoperative continuous
insulin infusion should be initiated to maintain serum glucose
level <180 mg/dL to reduce sternal wound infection.
1 B-R 2. In patients undergoing CABG, the use of continuous
intravenous insulin to achieve and maintain an early
postoperative blood glucose concentration of <180 mg/
dL while avoiding hypoglycemia is indicated to reduce the
incidence of adverse events, including deep sternal wound
infection.
1 B-NR 3. In patients undergoing CABG, a comprehensive approach to
reduce sternal wound infection is recommended.
2b B-R 4. In patients undergoing CABG, the usefulness of continuous
intravenous insulin designed to achieve a target intraoperative
blood glucose concentration <140 mg/dL is uncertain.
Pharmacotherapy in Patients Undergoing CABG
