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Effects of Intensive Blood Glucose Control on Surgical Site Infection for Liver Transplant Recipients: A Randomized Controlled Trial

Oliveira, Ramon Antônio; Tanner, Judith; Mancero, Jorge Marcelo Padilla; de Brito Poveda, Vanessa

Effects of Intensive Blood Glucose Control on Surgical Site Infection for Liver Transplant Recipients: A Randomized Controlled Trial Thumbnail


Authors

Ramon Antônio Oliveira

JUDITH TANNER Judith.Tanner@nottingham.ac.uk
Professor in Adult Nursing

Jorge Marcelo Padilla Mancero

Vanessa de Brito Poveda



Abstract

Background: The evidence supporting intensive blood glucose control to prevent surgical site infections (SSIs) among liver transplant recipients is insufficient. We aimed to assess the effects of postoperative intensive blood glucose control (IBGC) against standard blood glucose control (SBGC) on the incidence of SSIs among adult liver transplant recipients. Methods: We performed a randomized controlled trial (ClinicalTrials.gov identifier NCT03474666). The IBGC target was 80 to 130 mg/dL, and the SBGC target was below 180 mg/dL. Analyses were made on an intention-to-treat basis. Results: Of the 41 recipients enrolled onto the trial, 20 were randomly allocated to the IBGC group and 21 to the SBGC group. There were no significant differences in SSIs among recipients allocated to either group (relative risk [RR], 0.78; 95% confidence interval [CI], 0.21-2.88; P = .69). Mean (SD) blood glucose levels were significantly lower in the IBGC group in the 24-hour period after surgery (145.0 [20.7] mg/dL and 230.2 [51.6] mg/dL; P = .001). While there were fewer episodes of hypoglycemia in the IBGC group, this was not statistically significant. There were no episodes of severe hypoglycemia in either group. Hyperglycemia and severe hyperglycemia were significantly more frequent in the SBGC group (RR, 0.70; 95% CI, 0.52-0.93; P = .001 and RR, 0.07; 95% CI, 0.01-0.48; P = .001, respectively). Length of hospital stay was significantly shorter for recipients in the IBGC group (13.1 [5.5] days vs 19.3 [12.1] days; P = .04). Conclusions: Although this small trial did not find intensive control reduced SSI, it was associated with lower blood glucose levels, fewer episodes of hyperglycemia and severe hyperglycemia, and shorter length of hospital stay.

Citation

Oliveira, R. A., Tanner, J., Mancero, J. M. P., & de Brito Poveda, V. (2023). Effects of Intensive Blood Glucose Control on Surgical Site Infection for Liver Transplant Recipients: A Randomized Controlled Trial. Transplantation Proceedings, 55(1), 170-177. https://doi.org/10.1016/j.transproceed.2022.10.062

Journal Article Type Article
Acceptance Date Oct 18, 2022
Online Publication Date Dec 24, 2022
Publication Date 2023-01
Deposit Date Feb 2, 2023
Publicly Available Date Dec 25, 2023
Journal Transplantation Proceedings
Print ISSN 0041-1345
Electronic ISSN 1873-2623
Peer Reviewed Peer Reviewed
Volume 55
Issue 1
Pages 170-177
DOI https://doi.org/10.1016/j.transproceed.2022.10.062
Public URL https://nottingham-repository.worktribe.com/output/15924190
Publisher URL https://www.sciencedirect.com/science/article/pii/S0041134522007771?via%3Dihub
Additional Information January-February 2023 issue

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