Pro: glucose priming solutions should be used for cardiopulmonary bypass.
Current knowledge suggests that risks of glucose-containing solutions for patients undergoing CPB are hypothetical at best. Instead, patients may benefit from reduced perioperative fluid requirements bestowed by intraoperative glucose-containing solutions. This risk-benefit analysis does not apply to patients undergoing circulatory arrest. This population endures the certain risk of global CNS ischemia; furthermore, no studies address the effect of glucose on fluid requirements in this population. As the benefit of glucose during operations requiring circulatory arrest is unknown and the probable risk of exacerbating global CNS is high, deliberate hyperglycemia in this population is probably unwise. For patients undergoing CPB without circulatory arrest, the risk-benefit balance falls in favor of adding glucose. The contention that hyperglycemia worsens CNS deficits after cardiac operation is undocumented and may not be true. For their patients undergoing CPB, clinicians should seriously consider using glucose-containing priming solutions.
Department of Anesthesiology, Hahnemann University Hospital, Philadelphia, PA 19102-1192, USA.
S
S
Metz
D002315:Cardiopulmonary Bypass / Q000379:methods*; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D012306:Risk; D012996:Solutions
D012996:Solutions; D005947:Glucose