[The effects of insulin given prior to release of cross-clamp on coronary sinus lactate levels in coronary artery surgery].
OBJECTIVE
The aim of this study is to evaluate the effects of single dose insulin, given prior to reperfusion, in patients undergoing coronary artery bypass surgery (CABG).


METHODS
One hundred and twenty patients were prospectively randomized to be given either insulin (Group 1;n=60), or saline (Group 2;n= 60). Blood samples were taken 15 minutes before the reperfusion and insulin was given (0.3 IU/kg) to the patients in Group 1. Arterial and coronary sinus blood samples were taken, after the release of aortic cross-clamp (0. min), and 5th -10th -15th minutes of reperfusion. Arterial and coronary sinus lactate and glucose levels, postoperative insulin, inotropic and intraaortic balloon pump requirements; need for defibrillation and postoperative dysrhythmia, creatine kinase- MB (CPK-MB) levels, and length of stay in intensive care unit (ICU) and hospital were compared.


RESULTS
In Group 1, arterial lactate levels were found to be lower at 0.min, coronary sinus lactate levels were found to be lower at 0-5-10th minutes of reperfusion compared to Group 2. Similarly, defibrillation, glucose, postoperative insulin and inotrop requirements, postoperative arrhythmia and length of ICU stay were lower in Group 1. The CPK-MB levels and length of hospital stay were similar in all patients.


CONCLUSIONS
We conclude that single dose insulin given before the reperfusion period, has positive perioperative effects. Therefore it can be used in patients undergoing CABG surgery to decrease ischemia-reperfusion injury.
Savaşkan
Dilek
D
Yurtseven
Nurgül
N
Tuygun
Abdullah Kemal
AK
Aksoy
Pelin
P
Canik
Sevim
S
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D007362:Intensive Care Units; D019344:Lactic Acid / Q000097:blood*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D009206:Myocardium / Q000378:metabolism; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D016896:Treatment Outcome; D014421:Turkey
D007004:Hypoglycemic Agents; D007328:Insulin; D019344:Lactic Acid