[Impairment of glucose metabolism and changes in insulin activity during open heart surgery].
The examination of 147 surgical patients with cardiac diseases revealed that the onset of an operative intervention (skin incision) was accompanied with a substantial rise in endogenous insulin antibody titers in the blood of the operated patients, which is likely to trigger glucose metabolic disturbances. Insulin, 0.8-1.0 U/(kg/hour), and glucose, 0.4-0.5 g/(kg/hour), therapy (IGT) initiated prior to the skin incision and continued up to the application of forceps to the aorta was found to prevent the increase in insulin antibody titers both during the surgery and within 16-18 hours of the nearest postoperative period. IGT was demonstrated to improve myocardial contractility of patients in the preperfusion period and to provide an additional protection of the heart during its temporary anoxia. Insulin synthetic processes were activated in the nearest postoperative period in patients receiving IGT, unlike patients from the control group, the latter showing signs of diminished functional activity of B cells in the pancreas along with a moderate enhancement in the titer of antibodies to endogenous insulin. It was concluded that intraoperative IGT is a pathogenetically substantiated therapeutic modality in the complex of anesthetic supply during open heart surgeries.
Meshcheriakov
A V
AV
Lakhter
M A
MA
Kozlov
I A
IA
Dement'eva
I I
II
Ermolin
G A
GA
Galybin
A A
AA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D007328:Insulin / Q000502:physiology*; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D007328:Insulin
Narushenie metabolizma gliukozy i izmenenie aktivnosti insulina pri operatsiiakh na otkrytom serdtse.