Cardiothoracic & vascular anesthesia
Perioperative tight glucose control regimens for preventing surgical site infections following cardiac surgery-a systematic review and metanalysis of randomized controlled trials
Pooled result · SSIsResult — go to the resultRelative risk 0.53 95 % CI 0.42–0.68Authors' conclusion
This systematic review of the available evidence suggests that perioperative TGC, particularly when initiated at the start of surgery, may reduce the risk of SSIs following cardiac surgery. However, it increases the risk of hypoglycemia and does not significantly impact neurological outcomes and all-cause mortality.
Study context
- Population
- Adults undergoing cardiac surgery
- Participants
- 17,990 adults · 26 randomized controlled trials (RCTs)
- Comparison
- Perioperative tight glucose control vs conventional glucose management
- Outcome
- Incidence of surgical site infections (SSIs)
Methodological detailsGRADE certainty of evidence
- GRADE certainty of evidence
Pooled result
SSIs
Relative risk
0.53
95 % CI 0.42–0.68
TGC vs Control
RR 0.53 (95 % CI 0.42–0.68)
As reported in the abstract
Further pooled results
| Outcome | RR (95 % CI) | |
|---|---|---|
| SSIs, TGC initiated at start of surgery (subgroup)I2 = 0; low certainty evidence | 0.50 (0.39–0.66) | |
| SSIs, TGC initiated postoperatively (subgroup)I2 = 0; very low certainty evidence | 0.80 (0.39–1.66) | |
| 0.20.5125Relative risk (log scale) |
| Outcome | Shortened by (h) (95 % CI) |
|---|---|
| ICU LOSVery low certainty evidence | 7.03 (−10.83 to −3.22) |
- Intensive care unit (ICU) LOS: considerable heterogeneity (I2 = 92 %)
Neurological deficits and all-cause mortality
- No significant effects observed
Safety
| Outcome | RR (95 % CI) | |
|---|---|---|
| HypoglycemiaI2 = 0; moderate certainty evidence | 3.14 (2.37–4.16) | |
| 0.20.5125Relative risk (log scale) |
Original publication
Perioperative tight glucose control regimens for preventing surgical site infections following cardiac surgery-a systematic review and metanalysis of randomized controlled trials. J Clin Anesth. Published 3 November 2025. doi:10.
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