Literature DB >> 23198393

Our experience with two cardioplegic solutions: dextrose versus non-dextrose in adult cardiac surgery.

Ronald Lessen1, John DiCapua, Renee Pekmezaris, Rajni Walia, Karl Bocchieri, Lynda Jahn, Meredith Akerman, Martin L Lesser, Alan Hartman.   

Abstract

Intraoperative hyperglycemia has been observed to be associated with increased morbidity and mortality after cardiac surgery. Dextrose cardioplegia is used for its cardioprotective effects but may lead to intraoperative hyperglycemia and more postoperative complications. This was a retrospective observational study. Patient records (n = 2301) were accessed from a large database at a tertiary care facility. The two groups (dextrose vs. nondextrose) were then matched using preoperative variables of age, sex, body mass index, wound exposure time, preoperative HbA1c levels, renal failure, hypertension, and prior cerebrovascular disease. The following outcomes were recorded: 30-day mortality, sternal wound infection, stroke, and highest glucose level on cardiopulmonary bypass. The dextrose cardioplegia group showed statistically higher intraoperative glucose levels (272.76 +/- 55.92 vs. 182.79 +/- 45, p value = .0001). There was no difference in postoperative mortality, sternal wound infections or stroke incidence, nor in other secondary outcomes. The type of cardioplegia solution was shown to affect glucose levels; however, there was no effect on postoperative complication rates.

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Year:  2012        PMID: 23198393      PMCID: PMC4557524     

Source DB:  PubMed          Journal:  J Extra Corpor Technol        ISSN: 0022-1058


  11 in total

1.  Intensive insulin therapy in critically ill patients.

Authors:  G van den Berghe; P Wouters; F Weekers; C Verwaest; F Bruyninckx; M Schetz; D Vlasselaers; P Ferdinande; P Lauwers; R Bouillon
Journal:  N Engl J Med       Date:  2001-11-08       Impact factor: 91.245

2.  Elevated preoperative hemoglobin A1c level is predictive of adverse events after coronary artery bypass surgery.

Authors:  Michael E Halkos; John D Puskas; Omar M Lattouf; Patrick Kilgo; Faraz Kerendi; Howard K Song; Robert A Guyton; Vinod H Thourani
Journal:  J Thorac Cardiovasc Surg       Date:  2008-09       Impact factor: 5.209

3.  Glucose control lowers the risk of wound infection in diabetics after open heart operations.

Authors:  K J Zerr; A P Furnary; G L Grunkemeier; S Bookin; V Kanhere; A Starr
Journal:  Ann Thorac Surg       Date:  1997-02       Impact factor: 4.330

4.  Intraoperative physiologic variables and outcome in cardiac surgery: Part II. Neurologic outcome.

Authors:  G K van Wermeskerken; J W Lardenoye; S E Hill; H P Grocott; B Phillips-Bute; P K Smith; J G Reves; M F Newman
Journal:  Ann Thorac Surg       Date:  2000-04       Impact factor: 4.330

5.  Attempted control of hyperglycemia during cardiopulmonary bypass fails to improve neurologic or neurobehavioral outcomes in patients without diabetes mellitus undergoing coronary artery bypass grafting.

Authors:  John Butterworth; Lynne E Wagenknecht; Claudine Legault; Daniel J Zaccaro; Neal D Kon; John W Hammon; Anne T Rogers; B Todd Troost; David A Stump; Curt D Furberg; Laura H Coker
Journal:  J Thorac Cardiovasc Surg       Date:  2005-11       Impact factor: 5.209

6.  Hyperglycemia during cardiopulmonary bypass is an independent risk factor for mortality in patients undergoing cardiac surgery.

Authors:  Torsten Doenst; Duminda Wijeysundera; Keyvan Karkouti; Christoph Zechner; Manjula Maganti; Vivek Rao; Michael A Borger
Journal:  J Thorac Cardiovasc Surg       Date:  2005-10       Impact factor: 5.209

7.  Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures.

Authors:  A P Furnary; K J Zerr; G L Grunkemeier; A Starr
Journal:  Ann Thorac Surg       Date:  1999-02       Impact factor: 4.330

8.  Poor intraoperative blood glucose control is associated with a worsened hospital outcome after cardiac surgery in diabetic patients.

Authors:  Alexandre Ouattara; Patrick Lecomte; Yannick Le Manach; Marc Landi; Sophie Jacqueminet; Igor Platonov; Nicolas Bonnet; Bruno Riou; Pierre Coriat
Journal:  Anesthesiology       Date:  2005-10       Impact factor: 7.892

9.  Intensive intraoperative insulin therapy versus conventional glucose management during cardiac surgery: a randomized trial.

Authors:  Gunjan Y Gandhi; Gregory A Nuttall; Martin D Abel; Charles J Mullany; Hartzell V Schaff; Peter C O'Brien; Matthew G Johnson; Arthur R Williams; Susanne M Cutshall; Lisa M Mundy; Robert A Rizza; M Molly McMahon
Journal:  Ann Intern Med       Date:  2007-02-20       Impact factor: 25.391

10.  Glucose-insulin interactions during cardiopulmonary bypass. Hypothermia versus normothermia.

Authors:  F R Kuntschen; P M Galletti; C Hahn
Journal:  J Thorac Cardiovasc Surg       Date:  1986-03       Impact factor: 5.209

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  2 in total

1.  Comparison of blood electrolytes and glucose during cardiopulmonary bypass in diabetic and non-diabetic patients.

Authors:  Golamreza Maasoumi; Kianoush Saberi
Journal:  J Res Med Sci       Date:  2013-04       Impact factor: 1.852

2.  Diabetes and elevated preoperative HbA1c level as risk factors for postoperative delirium after cardiac surgery: an observational cohort study.

Authors:  Katarzyna Kotfis; Aleksandra Szylińska; Mariusz Listewnik; Mirosław Brykczyński; E Wesley Ely; Iwona Rotter
Journal:  Neuropsychiatr Dis Treat       Date:  2019-02-20       Impact factor: 2.570

  2 in total

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