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The effects of insulin given prior to release of cross-clamp on coronary sinus lactate levels in coronary artery surgery [Anatol J Cardiol]
Anatol J Cardiol. 2006; 6(3): 248-252

The effects of insulin given prior to release of cross-clamp on coronary sinus lactate levels in coronary artery surgery

Dilek Savaşkan1, Nurgül Yurtseven2, Abdullah Kemal Tuygun3, Pelin Aksoy4, Sevim Canik2
1Dr. Siyami Ersek Göğüs Kalp Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Göğüs Kalp Damar Cerrahisi Kliniği, İstanbul, Türkiye
2Department of Cardiovascular Anesthesia Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center istanbul, Turkey
3Dr. Siyami Ersek Göğüs Kalp Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Göğüs Kalp Damar Cerrahisi Klinikleri İstanbul, Türkiye
4Anadolu Sağlık Merkezi Anestezi Kliniği, İstanbul, Türkiye
5Department of Cardiovascular Anesthesia Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center istanbul, Turkey

Objective: The aim of this study is to evaluate the effects of single dose insulin, given prior to reperfusion, in patients undergoing coro- nary 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.

Keywords: Glucose,insulin,coronary artery bypass surgery


Dilek Savaşkan, Nurgül Yurtseven, Abdullah Kemal Tuygun, Pelin Aksoy, Sevim Canik. The effects of insulin given prior to release of cross-clamp on coronary sinus lactate levels in coronary artery surgery. Anatol J Cardiol. 2006; 6(3): 248-252


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