ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Maintenance of normoglycemia in diabetic patients during cardiac surgery: our clinical experiences
Aynur Camkıran1, Aslı Dönmez2, Sabiha Ercan3, Zeynep Kayhan1
1Başkent Üniversitesi Tıp Fakültesi Hastanesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara
2Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Ankara
3Halil İbrahim Özsoy Bolvadin Devlet Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Afyonkarahisar
DOI : 10.5606/tgkdc.dergisi.2011.081
Background: We investigated the efficacy of the anesthesia and routine cardiopulmonary bypass (CPB) protocol of our clinic on glycemia changes occurring during CPB in diabetic patients undergoing heart surgery and compared these changes with those of non-diabetic patients.

Methods: After ethics committee approval, 274 cases undergoing elective CPB surgery were included in this study and divided into two groups as diabetic (n=112) and non-diabetic (n=162) patients. Standard anesthetic, surgical, and CPB protocols were used in all patients. In accordance with the routine protocol of our clinic, diabetic patients received 5% dextrose by intravenous infusion at a fixed rate of 1.5 mg/kg/hr and insulin infusion. The insulin (50 units of regular insulin in 50 mL normal saline) infusion rate was adjusted according to the formula [units/hr= blood glucose (mg/dL)/100] that is used as our clinic's routine protocol. Blood glucose levels were measured before, during, and after CPB. The demographic data, duration of cross-clamping and CPB, intraoperative fluid management, and the amount of blood transfusions were recorded.

Results: The demographic characteristics of the diabetic group and the non-diabetic group were similar. There was a statistically significant increase in the glycemia levels of both groups from the baseline measurement values. The increase observed between the first and last glycemia level measurements was 37.16% and 43.04% in the diabetic and nondiabetic patients, respectively. It was observed that statistically significant increases from the baseline occurred in both groups; however, the glycemia levels of the group with diabetics showed less of an increase than in the non-diabetic group.

Conclusion: Our routine insulin-dextrose infusion protocol seems to be reliable for controlling blood glucose levels in diabetic patients who undergo CPB.

Keywords : Blood glucose; cardiac surgery; diabetes mellitus; glucose
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