Cardiothoracic & vascular anesthesia
Postoperative Ketoacidosis in Cardiac Surgery: Incidence, Analytical Profile, and Association With Sodium-Glucose Cotransporter 2 Inhibitors—A Prospective Observational Study
Authors' conclusion
Postoperative ketoacidosis, frequently euglycemic, is relatively common after cardiac surgery and strongly associated with SGLT2 inhibitor therapy.
Study context
- Population
- Adults undergoing elective cardiac surgery, cardiac intensive care unit (ICU) of a tertiary academic hospital, Madrid, Spain, July 2024–May 2025
- Participants
- 107 adults
- Exposure
- SGLT2 inhibitor users vs nonusers
- SGLT2 inhibitor usersn = 28
- Nonusersn = 79reference
- Outcome
- Postoperative ketoacidosis (arterial pH <7.30 and ketonemia ≥0.6 mmol/L, no preoperative ketoacidosis)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Postoperative ketoacidosis
P < 0.001
Observational data: associations, not effects.
Further findings
Bicarbonate, ketoacidosis vs no ketoacidosis
P = 0.012
| Outcome | Ketoacidosis | No ketoacidosis | OR | P value |
|---|---|---|---|---|
| Diabetes mellitus and ketoacidosisIndependently associated | 5.13 | P = 0.001 | ||
| Arterial pH, ketoacidosis vs no ketoacidosis | 7.31 | 7.35 | P < 0.001 | |
| Base excess, ketoacidosis vs no ketoacidosis | −4.2 | −2.6 | P = 0.03 |
ICU LOS, duration of mechanical ventilation, reintervention, mortality
- No significant differences
Original publication
Postoperative Ketoacidosis in Cardiac Surgery: Incidence, Analytical Profile, and Association With Sodium-Glucose Cotransporter 2 Inhibitors—A Prospective Observational Study. J Cardiothorac Vasc Anesth. Published 13 November 2025. doi:10.
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