Abstract: Objective To explore the predictive value of intraoperative glucose coefficient of variation(CV) for pulmonary infection after off-pump coronary artery bypass surgery(OPCABG).Methods A total of 401 patients who were subject to OPCABG and admitted to the Intensive Care Unit, the Affiliated Hospital of Xuzhou Medical University from January 2017 to July 2022 were enrolled. According to the presence of postoperative pulmonary infection, they were divided into two groups: an infection group and a non-infection group. Multivariate logistic regression analysis was used to screen the independent risk factors for postoperative pulmonary infection in OPCABG patients. A receiver operator characteristic curve(ROC) was plotted to assess the predictive value of intraoperative CV for postoperative pulmonary infection in OPCABG patients.Results In the current study, the overall incidence of pulmonary infection after OPCABG was 23%. Compared with the non-infection group, the infection group showed significantly increased intraoperative CV levels(P＜0.05). Furthermore, significant differences were found in lactic acid(Lac), neutrophil/lymphocyte count ratio(NLR), procalcitonin(PCT), interleukin-6(IL-6), concurrent other surgery, the Acute Physiology and Chronic Health Evaluation II(APACHE II) score and the total length of hospitalization stay between the two groups(P＜0.05). According to multivariate logistic regression analysis, intraoperative CV, Lac, IL-6, concurrent other surgery, APACHE II score and the total length of hospitalization stay were the independent risk factors for pulmonary infection after OPCABG. Furthermore, the area under the ROC(AUC) of intraoperative CV in predicting pulmonary infection after OPCABG was 0.719(95% CI 0.659-0.780). When the cut-off value of intraoperative CV was 13.404%, the sensitivity was 0.641, the specificity was 0.699, and the Yordon index was 0.340.Conclusions Intraoperative CV is an independent risk factor for postoperative pulmonary infection in OPCABG patients and can be used as a predictive indicator.