MPOG Cardiac Anesthesia Subcommittee Meeting
October 5, 2026
Agenda
• Welcome & announcements
• GLU-06-C Measure Review
• GLU-08-C Measure Review
• GLU-07-C Measure Review
• GLU-14-C
• Summary and next steps
Introductions
• ASPIRE Quality Team
– Allison Janda, MD – MPOG Cardiac Anesthesia Committee Chair
– Ashan Grewal, MD – MPOG Cardiac Anesthesia Committee Vice Chair
– Megan Charette, MPH, MBA, RN – QI Specialist
• Cardiac Anesthesiology Representatives joining us from around the US!
Announcements
• Please reach out if you would like to add any colleagues to the subcommittee
• ABX-02, ABX-03, ABX-04, and ABX-05 are up for review in the spring – seeking
volunteers!
• Upcoming MPOG Retreat, Friday, October 16 in San Diego:
o Register here (in-person and virtual!)
• VANISH-AKI introduction and summary
PCORI Grant submission: VANISH AKI
Open label Multicenter RCT comparing Vasopressin vs. Norepinephrine as
the first infusion in cardiac surgical patients.
Primary end point: KDIGO Adjudicated AKI (postoperatively)
All cardiac surgical patients needing cardiopulmonary bypass
Exclusion: preexisting ESRD
Planning to invite 16-18 sites
PCORI Grant submission: VANISH AKI
Recruitment Goal : 3700 subjects
Recruitment Goal ~ 60 subjects /site/ year
Surveys will be sent out shortly
GLU-06-C at a Glance
Hyperglycemia Management, Open Cardiac (>180 mg/dL/>10mmol/L)
Measure Description:
Percentage of adult patients undergoing an open cardiac procedure for whom any intraoperative blood glucose value did not
exceed 180 mg/dL (10.0 mmol/L).
Who is measured:
Adults undergoing open cardiac procedures (value code: 1)
Exclusion: age < 18 years, organ procurement cases (value code: 1), and non-cardiac, transcatheter/endovascular, EP/cath, and
other cardiac cases (value codes: 0, 2, 3, and 4)
How it is assessed:
Passed – Blood glucose remained ≤ 180 mg/dL (10.0 mmol/L)
Flagged – Blood glucose >180mg/dL (10.0 mmol/L)
Flagged – No blood glucose values
When it is assessed:
Anesthesia start through 30 minutes after anesthesia end
Why it matters:
The ≤180 mg/dL target aligns with cited cardiac-surgery guidance and literature supporting perioperative glucose
management.
GLU-06-C Performance
September 2025 – August 2026
Reviewer Recommendation for GLU-06-C
Modify: changes to measure specifications (see below)
o Adjust the 30-minute window for rechecking to 60-minutes.
o Add additional flag criteria in Other Measure Details
▪ “Blood glucose >180mg/dL is not rechecked" = flagged
GLU-06-C
1 vote per site
Continue as is / modify / retire
Need > 50% to retire measure
Coordinating center will review all votes after meeting
to ensure no duplication
GLU-08-C at a Glance
Hyperglycemia Treatment, Open Cardiac (>180mg/dL/>10.00mmol/L)
Measure Defined:
Percentage of adult patients undergoing open cardiac surgical procedures for whom any intraoperative blood glucose value
≥180 mg/dL was either treated with insulin or rechecked and found to be <180 mg/dL within 30 minutes.
Who is measured:
Adults undergoing open cardiac procedures (value code: 1)
Exclusion: age < 18 years, organ procurement cases (value code: 1), and non-cardiac, transcatheter/endovascular, EP/cath, and
other cardiac cases (value codes: 0, 2, 3, and 4)
How it is assessed:
Passed – High glucose treated
Flagged – High glucose not treated
Flagged – No blood glucose values
When it is assessed:
Anesthesia start through 30 minutes after anesthesia end
Why it matters:
The ≥180 mg/dL treatment threshold is consistent with Society of Thoracic Surgeons (STS) guidelines and other cardiac surgery
perioperative care recommendations supporting glucose management to improve outcomes and reduce complications in
cardiac surgery patients.
GLU-08-C Performance
September 2025 – August 2026
Reviewer Recommendation for GLU-08-C
Modify: changes to measure specifications (see below)
o Adjust the 30-minute window for rechecking to 60-minutes.
o Modify provider attribution: "=" signs should be ">" or "<"
▪ Step 1 modifications:
▪ All glucose values during the provider’s time are > 180 mg/dL, proceed to Step 2 to
assess recent pre–sign-in values.
▪ If any glucose value is > 180 mg/dL during sign-in:
o The provider will pass if either:
▪ Insulin is administered within 30 minutes of each high glucose value, or
▪ Glucose is rechecked within 30 minutes of each high glucose value and the
repeat value(s) are < 180 mg/dL.
▪ Step 2 modifications:
▪ If the high glucose value was treated with insulin or rechecked within 30 minutes (with a
resulting value < 180 mg/dL), the provider will pass.
▪ If the high glucose value was not treated and not rechecked within 30 minutes, the
provider will flag, even if all remaining glucose values during sign-in are < 180 mg/dL.
▪ Change 30-minute windows to 60-minute windows
GLU-08-C
1 vote per site
Continue as is / modify / retire
Need > 50% to retire measure
Coordinating center will review all votes after meeting
to ensure no duplication
GLU-07-C at a Glance
Hypoglycemia Management, Open Cardiac (<70mg/dL/<3.885mmol/L)
Measure Description:
Percentage of adult patients, undergoing open cardiac surgery with any intraoperative blood glucose value < 70 mg/dL.
Who is measured:
Adults undergoing open cardiac procedures (value code: 1)
Exclusion: age < 18 years, organ procurement cases (value code: 1), and non-cardiac, transcatheter/endovascular, EP/cath, and
other cardiac cases (value codes: 0, 2, 3, and 4)
How it is assessed:
Passed – Blood glucose remained ≥ 70 mg/dL (3.885 mmol/L)
Flagged – Blood glucose < 70 mg/dL (3.885 mmol/L)
Flagged – No blood glucose values
When it is assessed:
Anesthesia start through 15 minutes after anesthesia end
Why it matters:
Early recognition and treatment of hypoglycemia helps prevent serious complications and supports evidence-based
perioperative glucose
GLU-07-C Performance
September 2025 – August 2026
Reviewer Recommendation for GLU-07-C
Overall recommendation: Continue as is
• Continues to be highly appropriate and indeed a critical metric as a
counterweight to include alongside other ASPIRE measures that may induce
providers to administer insulin during these same procedures.
• This is important as was demonstrated in the NICE-SUGAR study that is already
referenced and which convincingly demonstrating the dangers of overly tight
glucose targets in hospitalized adults.
• Related note: Could revisit the cardiac procedure type phenotype as some cases
are appearing that shouldn't
GLU-07-C
1 vote per site
Continue as is / modify / retire
Need > 50% to retire measure
Coordinating center will review all votes after meeting
to ensure no duplication
New Measure: GLU-14-C Performance
Released: 6/1/2026
GLU-14-C at a Glance
Successful Treatment of Hyperglycemia, Open Cardiac
Measure Defined:
Percentage of adult patients (≥18 years) undergoing open cardiac surgery under general anesthesia (duration ≥120 minutes)
whose last intraoperative blood glucose before anesthesia end is ≤180 mg/dL (10.0 mmol/L).
Who is measured:
Adults undergoing open cardiac procedures (value code: 1) under general anesthesia of 120 minutes duration or longer
Exclusion: age < 18 years, organ procurement cases (value code: 1), and non-cardiac, transcatheter/endovascular, EP/cath, and
other cardiac cases (value codes: 0, 2, 3, and 4), case duration < 120 minutes
How it is assessed:
Passed – Last intraoperative blood glucose level before anesthesia end ≤ 180 mg/dL (10.0 mmol/L)
Flagged – Last blood glucose > 180mg/dL (10 mmol/L)
Flagged – Last blood glucose > 180mg/dL (10 mmol/L) AND First blood glucose > 180mg/dL (10 mmol/L)
When it is assessed:
Anesthesia start to anesthesia end
Why it matters:
Controlling intraoperative hyperglycemia during open cardiac surgery helps reduce postoperative complications and improve
patient outcomes.
GLU-14-C Performance
September 2025 – August 2026
Measure Review Process
• Review literature for given
measure topic and provide review
using MPOG Measure Review
Template
• Present review of literature and
recommendations at Cardiac
Subcommittee meetings
• Reviewers names will be added to
measure specifications as well as
MPOG Measure Reviewer website
Upcoming Cardiac-Focused Measure Reviews
Measure
Review Date
Reviewers
ABX-02-C March 2027
ABX-03-C March 2027
ABX-04-C March 2027
ABX-05-C March 2027
FLUID-01-C June 2027
Thank you in advance for ensuring MPOG Cardiac-specific measures remain relevant &
consistent with published recommendations!
Contact Allison with any questions: ajanda@med.umich.edu
Cardiac Anesthesia Subcommittee Membership
• Open to all anesthesiologists or those interested in improving cardiothoracic
measures
– Do not have to practice at an active MPOG institution
• Proposed 2027 Meeting Schedule
– March 2027
– July 2027
– November 2027
• Thank you for using the forum for discussion between meetings
