title: Preoperative glutamine infusion improves glycemia in heart surgery patients.
abstract: OBJECTIVE
  To evaluate the effects of pre-operative L-alanyl-glutamine (L-Ala-Gln) on blood glucose control in patients with coronary obstruction, selected for myocardial revascularization.
  
  
  METHODS
  Twenty-two patients (63±8 years) were randomly assigned to receive 250 ml of L-Ala-Gln 20% plus saline 750 ml (Group L- Ala-Gln, n=11) or saline 1000 ml (Group Saline, n=11) over 3 hours before operation. Pre-operative blood samples were collected 3h before (T-1) and at the beginning of the surgical procedure (T-2). Intra-operative samples were collected immediately before the start (T-3) and the end of extra-corporeal perfusion (T- 4). Post-operative samples were collected 12h (T-12) and 24h later (T-24).
  
  
  RESULTS
  Glycemia decreased significantly in L-Ala-Gln treated patients during the intraoperative period. The same effect did not occur in saline patients. As the rate of insulin infusion, administered routinely to patients undergoing surgery with extracorporeal circulation was constant in both groups during surgery, the reduction of blood glucose in group L-Ala-Gln does not seem to be related to exogenous insulin.
  
  
  CONCLUSIONS
  Pre-operative use of L-Ala-Gln improves glycemic control in patients with coronary artery occlusion, submitted to myocardial revascularization.
authors.affiliation: Walter Cantidio Hospital and Experimental Surgery Research Laboratory (LABCEX), Federal University of Ceara, Fortaleza-CE, Brazil.
authors.forename: Miguel Nasser
authors.initials: MN
authors.lastname: Hissa
authors.forename: Raquel Cavalcante de
authors.initials: RC
authors.lastname: Vasconcelos
authors.forename: Sergio Botelho
authors.initials: SB
authors.lastname: Guimarães
authors.forename: Ricardo Pereira
authors.initials: RP
authors.lastname: Silva
authors.forename: José Huygens Parente
authors.initials: JH
authors.lastname: Garcia
authors.forename: Paulo Roberto Leitão de
authors.initials: PR
authors.lastname: Vasconcelos
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001786:Blood Glucose / Q000187:drug effects*; D003324:Coronary Artery Disease / Q000378:metabolism / Q000601:surgery*; D004311:Double-Blind Method; D005973:Glutamine / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D007328:Insulin / Q000097:blood; D008875:Middle Aged; D009204:Myocardial Revascularization; D057234:Preoperative Period; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007328:Insulin; D005973:Glutamine; D012965:Sodium Chloride