The Importance of Monitoring Blood Glucose Test in Patients Post-operative Coronary Artery Bypass Graft Surgery

Abit Mawan Dayoko, Tri Gunarti, Fitria Habibah Nita Yuliana Eka Putri

Abstract

Hyperglycemia is a risk factor for cardiac surgery-associated acute kidney injury in post-operative coronary artery bypass graft surgery patients. Glycemic control is important to prevent cardiac surgery-associated acute kidney injury. Postoperative glycemic control suggested 110-150 mg/dL. The aims of this study were to lower blood glucose levels and reduce the risk of occurrence or severity of cardiac surgery-associated acute kidney injury in post coronary artery bypass graft surgery patients. This study was conducted with a case study design involving 2 post operative coronary artery bypass graft patients who experienced hyperglycemia on the 1st to the 3rd day of treatment. Data collection was carried out from May 22 to May 23, 2023. The results of the case study showed that monitoring blood glucose in post-cardiac surgery patients is very important. Both patients experienced hyperglycemia in the early postoperative phase. With close monitoring and administration of insulin therapy according to the doctor's advice, the blood sugar levels of both patients were controlled. Monitoring urine output and evaluating serum creatinine levels showed that the first patient had cardiac surgery-associated acute kidney injury stage 1 on day 2 and showed improvement on day 3. The second patient did not develop cardiac surgery-associated acute kidney injury. The role of critical nurses in monitoring blood glucose levels and administering insulin doses is supported by related research. Strict monitoring and target ranges of blood glucose levels, in collaboration with the medical team are necessary to reduce the risk of cardiac surgery-associated acute kidney injury events.

Keywords

Acute Kidney Injury, Coronary Artery Bypass Graft Surgery, Glycemic control

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References

Al-githmi, I. S., Abdulqader, A. A., Alotaibi, A., Aldughather, B. A., Alsulami, A., Wali, S. M., Alghamdi, M. S., Althabaiti, T. S., & Melebary, T. B. (2022). Acute Kidney Injury After Open Heart Surgery. 14(6), 10–15. https://doi.org/10.7759/cureus.25899

Brush, J. E., Siraj, E. S., Kemp, C. D., Liverman, D. P., McMichael, B. Y., Lamichhane, R., & Sheehan, B. E. (2019). Effect of Diabetes Mellitus on Complication Rates of Coronary Artery Bypass Grafting. American Journal of Cardiology, 124(9), 1389–1396. https://doi.org/10.1016/j.amjcard.2019.07.053

Bunney, P. E., Zink, A. N., Holm, A. A., Billington, C. J., & Kotz, C. M. (2017). Orexin activation counteracts decreases in nonexercise activity thermogenesis (NEAT) caused by high-fat diet. Physiology and Behavior, 176, 139–148. https://doi.org/10.1016/j.physbeh.2017.03.040

Gorelik, Y., Bloch-Isenberg, N., Hashoul, S., Heyman, S. N., & Khamaisi, M. (2022). Hyperglycemia on admission predicts acute kidney failure and renal functional recovery among inpatients. Journal of Clinical Medicine, 11(1). https://doi.org/10.3390/jcm11010054

Hall, J. E., & Guyton, A. C. (2016). Guyton and Hall Textbook of Medical Physiology. In Pharmaceutical Research: An Official Journal of the American Association of Pharmaceutical Scientists (13th ed., Vol. 12, Issue 3). elsevier. https://doi.org/10.1023/A:1016212804288

KDIGO. (2017). The interpretation of KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Official Journal Of The International Society Of Nephrology, 17(8), 869–875. https://doi.org/10.7507/1672-2531.201708015

Khan, B., Rehman, M. U., Islam, M. U., & Ahmad, I. (2023). Prevalence of diabetes mellitus in patients undergoing coronary artery bypass grafting in a Tertiary Care Hospital. Indonesian Journal of Cardiology, 39(Suppl_B), 1–12. https://doi.org/10.30701/ijc.v39isuppl_b.854

Leininger, S. (2018). Blood Glucose Management for reducing cardiac surgery infections. Critical Care Nursing Quarterly, 41(4), 399–406. https://doi.org/10.1097/CNQ.0000000000000227

Levy, J. H., Lobdell, K., Fletcher, N., Kirsch, M., Nelson, G., Engelman, R. M., Gregory, A. J., & Boyle, E. M. (2019). Guidelines for Perioperative Care in Cardiac Surgery Enhanced Recovery After Surgery Society Recommendations. 154(8), 755–766. https://doi.org/10.1001/jamasurg.2019.1153

Liu, Y., Sun, X. X., Du, W. Y., Chen, T. T., & Lv, M. (2022). Intensive versus conservative glycemic control in patients undergoing coronary artery bypass graft surgery: A protocol for systematic review of randomised controlled trials. PLoS ONE, 17(10 October), 1–8. https://doi.org/10.1371/journal.pone.0276228

Long, C. A., Fang, Z. B., Hu, F. Y., Arya, S., Brewster, L. P., Duggan, E., & Duwayri, Y. (2019). Poor glycemic control is a strong predictor of postoperative morbidity and mortality in patients undergoing vascular surgery. Journal of Vascular Surgery, 69(4), 1219–1226. https://doi.org/10.1016/j.jvs.2018.06.212

Mendez, C. E., Der Mesropian, P. J., Mathew, R. O., & Slawski, B. (2016). Hyperglycemia and acute kidney injury during the perioperative period. Current Diabetes Reports, 16(1). https://doi.org/10.1007/s11892-015-0701-7

Patschan, D., & Müller, G. A. (2016). Acute Kidney Injury in Diabetes Mellitus. International Journal of Nephrology 2016, 1(7). https://doi.org/10.1155/2016/6232909

PERKENI, PERDICI, PERDOSSI, P. (2018). Penatalaksanaan Hiperglikemia di Ruang Rawat Intensif (T. J. E. Tarigan & F. J. V Pangalila (eds.)). PERDICI.

PPNI. (2017). Standar Doagnosis Keperawatan Indonesia (Aprisunadi (ed.); 3rd ed.). DPP PPNI.

PPNI. (2018). Standart Intervensi Keperawatan Indonesia (Aprisunadi (ed.); 2nd ed.). DPP PPNI.

Rayhan, M., & Joe, J. (2021). Hubungan Kontrol Glikemik Preoperatif Dan Gangguan Ginjal Akut Pasca Coronary Arterial Bypass Grafting Pada Pasien Diabetes Mellitus. IJCNP (INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN), 4(1), 63–73. https://doi.org/10.54773/ijcnp.v4i1.63

Robich, M. P., Iribarne, A., Leavitt, B. J., Malenka, D. J., Quinn, R. D., Olmstead, E. M., Ross, C. S., Sawyer, D. B., Klemperer, J. D., Clough, R. A., Kramer, R. S., Baribeau, Y. R., Sardella, G. L., & DiScipio, A. W. (2019). Intensity of Glycemic Control Affects Long-Term Survival After Coronary Artery Bypass Graft Surgery. Annals of Thoracic Surgery, 107(2), 477–484. https://doi.org/10.1016/j.athoracsur.2018.07.078

Song, J. W., Shim, J. K., Yoo, K. J., Oh, S. Y., & Kwak, Y. L. (2013). Impact of intraoperative hyperglycaemia on renal dysfunction after off-pump coronary artery bypass. Interactive Cardiovascular and Thoracic Surgery, 17(3), 473–478. https://doi.org/10.1093/icvts/ivt209

Sugiyono. (2018). Metode Penelitian Pendidikan Pendekatan Kuantitatif, Kualitatif dan R&D. Alfabeta.

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