A retrospective analysis of blood gases with two different insulin infusion protocols in patients undergoing cardiovascular surgery.
OBJECTIVE
Intraoperative blood glucose concentration is known to be an independent risk factor for morbidity and mortality in patients undergoing cardiovascular surgery. Arterial blood gas analysis is an important investigation to monitor the acid-base balance and gas exchange in these patients. Hyperglycemia leads to a series of metabolic changes which affect acid-base balance and serum electrolytes. In this study, we aimed to look into the effect of glycemic control on arterial blood gas parameters, serum electrolytes, and hemoglobin (Hb).


METHODS
We collected data from diabetic patients who underwent cardiovascular surgery between 2010 and 2014. The patients were divided into two groups according to the insulin infusion protocols applied such as with conventional (180-250 mg/dl) (n = 17) (Group 1) and tighter glycemic targets (121-180 mg/dl) (n = 51) (Group 2). We retrospectively analyzed arterial blood gas results taken at different perioperative time points from these patients.


RESULTS
We found that pH HCO3and base excess, serum sodium, potassium, calcium, and Hb were similar in both groups.


CONCLUSIONS
Our study showed that a tighter intraoperative glycemic control does not affect arterial blood gas parameters, serum electrolytes, or Hb when compared to the conventional glycemic control.
Department of Endocrinology and Metabolism, Medical Faculty, Gazi University, Ankara, Turkey.
S M
SM
Kuskonmaz
Department of Anaesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, Turkey.
Ö
Ö
Kurtipek
Department of Anaesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, Turkey.
M E
ME
Aydın
Department of Anaesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, Turkey.
M E
ME
Erbatur
Department of Anaesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, Turkey.
M
M
Alkan
Department of Anaesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, Turkey.
Y
Y
Ünal
Department of Anaesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, Turkey.
M
M
Arslan
D000137:Acid-Base Imbalance; D000368:Aged; D001784:Blood Gas Analysis; D001786:Blood Glucose / Q000032:analysis* / Q000378:metabolism; D006348:Cardiac Surgical Procedures; D003920:Diabetes Mellitus / Q000517:prevention & control; D005260:Female; D005740:Gases; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D001786:Blood Glucose; D005740:Gases; D007328:Insulin