Hypoglycemic coma after cardiac surgery.
Hypoglycemic coma occurring 5 h after cardiac surgery in a nondiabetic adult patient was primarily triggered by: low cardiac output leading to severe hepatic functional derangement; metabolic acidosis, probably secondary to peripheral hypoperfusion; and possible inhibition of the adrenergic response due to anesthesia with fentanyl. Glucose infused at 8 g/h progressively increased the blood glucose level and paralleled hemodynamic improvement.
D000138:Acidosis / Q000209:etiology; D000328:Adult; D001022:Aortic Valve Insufficiency / Q000601:surgery; D002303:Cardiac Output, Low / Q000209:etiology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003128:Coma / Q000209:etiology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D008946:Mitral Valve Stenosis / Q000601:surgery; D011183:Postoperative Complications