Glycemic control during pancreas transplantation: continous infusion versus bolus.
Pancreas transplantation is a method to restore endogenous insulin secretion in insulin-dependent diabetic patients. Because glycemia >150 mg/dL may harm pancreatic graft beta cells, early glucose control using insulin administration is recommended during transplantation. The aim of this study was to evaluate the benefits of strict glycemic control during pancreas transplantation by comparing two types of insulin and glucose administration: continuous infusion and bolus. Capillary glucose was measured every 30 minutes after anesthetic induction for pancreas transplantation alone or simultaneously with kidney transplantation. Intravenous regular insulin was administered for values >150 mg/dL or glucose for values <100 mg/dL. The following timepoints were evaluated: anesthetic induction, before pancreatic graft reperfusion, and the first 4 minutes after reperfusion. Pancreatic graft ischemia time was significantly lower in the bolus group (P <.02). Immediately after reperfusion, there was a small increase in glycemia with a decrease in subsequent measurements in both groups. No significant difference in glycemia was observed between the groups at any time. Induction values were greater than all other timepoints in both groups. Glycemic control is important; it was successfully obtained with both methods. The trend to decrease glucose after reperfusion suggest early graft function.
Halpern
H
H
Albert Einstein Jewish Hospital, Sao Paulo, SP Brazil. hhalpern@einstein.br
Miyoshi
E
E
Kataoka
L M
LM
Fo
R A Khouri
RA
Miranda
S B P
SB
Marumo
C K
CK
Caravatto
P P P
PP
Genzini
T
T
Miranda
M P
MP
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000601:surgery; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D016343:Monitoring, Intraoperative; D016035:Pancreas Transplantation / Q000379:methods*
D001786:Blood Glucose