Glycaemic Control and its Impact on Early Post-Operative Outcomes in Patients undergoing Minimally Invasive Cardiac Surgery

Background: Minimally invasive cardiac surgery (MICS) offers benefits such as reduced surgical trauma and faster recovery. However, intraoperative hyperglycaemia during cardiopulmonary bypass (CPB) is a concern due to its association with adverse outcomes. While glycemic control has been studied in conventional cardiac procedures, limited data exist on its impact in MICS. Objective: To assess whether intraoperative blood glucose levels influence early postoperative outcomes in patients undergoing MICS. Methodology: A retrospective observational study at a tertiary care hospital was conducted over 8.5 months. 40 patients undergoing elective MICS were divided into two groups based on intraoperative blood glucose levels: Group A (≤200 mg/dL, n=15) and Group B (≥201 mg/dL, n=25). Preoperative, intraoperative, and postoperative data were collected, including neurocognitive outcomes (Mini-Mental State Examination), duration of mechanical ventilation, ICU stay, and need for inotropic support. Statistical analysis was performed using SPSS v26.0 with p<0.05 considered significant. Results: Baseline characteristics were comparable, except for higher creatinine clearance in the hyperglycaemic group. No significant differences were found in neurocognitive function or mechanical ventilation time between groups. However, a trend toward longer ICU stays was observed in Group B (p=0.082), and cooling temperatures during CPB were significantly higher in this group (p=0.046). One mortality occurred in the hyperglycaemic group. Conclusion: Although not all findings reached statistical significance, intraoperative hyperglycaemia in MICS was associated with increased ICU stay and cooling intervention requirements. These findings suggest a potential role for improved intraoperative glucose management to support better recovery and resource efficiency in MICS. Larger, prospective studies are recommended. KEYWORDS: Glycemic Control, Minimally Invasive Cardiac Surgery, Cardiopulmonary Bypass, Hyperglycaemia, Postoperative Outcomes, Neurocognitive Function, ICU Stay