[The effect of heart surgery during extracorporeal circulation and deep hypothermia on glucose metabolism in infants and young children].
Authors examined levels of glucose, insulin, and C-peptide in the plasma of 6 infants and small children with the isolated transposition of the great arteries (3 pts) and ventricular septal defect (3 pts) in the course of open-heart surgery in deep hypothermia. The mean age of the patients was 7.2 months (6 to 15) and weight 5.6 kg (5.2-7.5). Exogenous intake of glucose during the operation was excluded. Methods of anaesthesia, operation technique, and conduction of extracorporeal circulation (ECC) were constant in all patients. Fresh ACD blood diluted with Hartman solution approximately 1:1 was used for the prime of ECC circuit (content 800 ml) to get the hematocrit 0.27 +/- 0.2 after mixing the prime with the patient's blood volume. Glycemia was determined by Beckman ERA 2001 analyzor, and levels of insulin and C-peptide by radioimmunoassay kits MJ-96 (Poland) and Novo (Denmark). Significant hyperglycemia was found in all patients during the period of hypothermia, and was overlasting to the rewarming period until the end of the operation and 1 hour postoperatively. Then level of glycemia was decreasing to the normal values which were found in the last sample (17 hours post-op). The raise of glycemia was not a stimulus to the proportional increase of insulin and C-peptide levels in plasma. It proved transitional suppress of insulin secretion in the beta cells of the pancreas in the cooling period. Levels of insulin and C-peptide significantly and concordantly increased after 20 min. of rewarming (r = 0.83). However, hyperglycemia overlasted during the course of rewarming, too.(ABSTRACT TRUNCATED AT 250 WORDS)
Kucera
V
V
Vavrinec
J
J
Dvorák
P
P
Hucín
B
B
D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood; D006348:Cardiac Surgical Procedures; D002675:Child, Preschool; D005112:Extracorporeal Circulation; D006330:Heart Defects, Congenital / Q000097:blood / Q000601:surgery; D006801:Humans; D007036:Hypothermia, Induced; D007328:Insulin / Q000097:blood
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin
Vliv operace srdce v mimotĕlním obĕhu a v hluboké hypotermii na metabolismus glukózy u kojenců a malých dĕtí.