Glycemic control after coronary bypass graft: using intravenous insulin regulated by a computerized system.

Hyperglycemia is a risk factor for poor outcomes in patients who undergo coronary artery bypass grafting. Poor outcomes led a multidisciplinary team to formulate a protocol to improve glycemic control of inpatients who had diabetes or hyperglycemia. This protocol initiated an intravenous (i.v.) insulin infusion that is regulated by a computerized system that is known as a Glucommander, and guides the surgeon and nurses to an easy transition to subcutaneous insulin. As a result of implementing the computerized system which regulated i.v. insulin, glycemic control improved during surgery and postoperatively. Additionally, physician and nurse satisfaction increased because of better glycemic control using a reliable, safe, and easy tool for the management of insulin infusions and there were fewer interruptive phone calls to physicians.