title: Intravenous insulin therapy during lung resection does not affect lung function or surfactant proteins.
abstract: BACKGROUND
  The surgical resection of lung disrupts glucose homeostasis and causes hyperglycemia, as in any other major surgery or critical illness. We performed a prospective study where we carefully lowered hyperglycemia by insulin administration during the surgery, and for the first time we monitored immediate insulin effects on lung physiology and gene transcription.
  
  
  METHODS
  The levels of blood gases (pH, pCO2, pO2, HCO3-, HCO3- std, base excess, FiO2, and pO2/FiO2) were measured at the beginning of surgery, at the end of surgery, and two hours after. Samples of healthy lung tissue surrounding the tumour were obtained during the surgery, anonymized and sent for subsequent blinded qPCR analysis (mRNA levels of surfactant proteins A1, A2, B, C and D were measured). This study was done on a cohort of 64 patients who underwent lung resection. Patients were randomly divided, and half of them received insulin treatment during the surgery.
  
  
  RESULTS
  We demonstrated for the first time that insulin administered intravenously during lung resection does not affect levels of blood gases. Furthermore, it does not induce immediate changes in the expression of surfactant proteins.
  
  
  CONCLUSIONS
  According to our observations, short insulin treatment applied intravenously during resection does not affect the quality of breathing.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Ručka
authors.affiliation: Masaryk University, Faculty of Informatics, Centre for Biomedical Image Analysis, Botanická 68a, 60200 Brno, Czech Republic. qkoutna@fi.muni.cz.
authors.forename: Irena
authors.initials: I
authors.lastname: Koutná
authors.forename: Lenka
authors.initials: L
authors.lastname: Tesařová
authors.forename: Michaela
authors.initials: M
authors.lastname: Potěšilová
authors.forename: Stanislav
authors.initials: S
authors.lastname: Stejskal
authors.forename: Pavel
authors.initials: P
authors.lastname: Simara
authors.forename: Petr
authors.initials: P
authors.lastname: Vaňhara
authors.forename: Jan
authors.initials: J
authors.lastname: DoleŽel
authors.forename: Vaclav
authors.initials: V
authors.lastname: Zvoníček
authors.forename: Oldřich
authors.initials: O
authors.lastname: Coufal
authors.forename: Ivan
authors.initials: I
authors.lastname: Capov
mesh_terms: D000137:Acid-Base Imbalance; D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001639:Bicarbonates / Q000097:blood; D001784:Blood Gas Analysis; D001786:Blood Glucose / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D015870:Gene Expression / Q000187:drug effects; D006801:Humans; D006863:Hydrogen-Ion Concentration; D006943:Hyperglycemia / Q000188:drug therapy* / Q000209:etiology; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D008168:Lung / Q000187:drug effects / Q000503:physiopathology*; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011013:Pneumonectomy / Q000009:adverse effects; D011446:Prospective Studies; D037661:Pulmonary Surfactant-Associated Proteins / Q000235:genetics*; D012333:RNA, Messenger / Q000378:metabolism; D013997:Time Factors
chemical_list: D001639:Bicarbonates; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D037661:Pulmonary Surfactant-Associated Proteins; D012333:RNA, Messenger; D002245:Carbon Dioxide; D010100:Oxygen