EFFECTS OF OPEN-HEART SURGERY ON GLUCOSE METABOLISM ESPECIALLY, ENDOCLINOLOGICAL REGULATION FOR HYPERGLYCEMIA DURING AND AFTER THE OPERATION

• Published in: The KITAKANTO Medical Journal Vol. 33; no. 2; pp. 111 - 124
• Main Author: HIRAI, AKIFUMI
• Format: Journal Article
• Language: English
• Published: The Kitakanto Medical Society 10.05.1983
• Subjects: C-peptide; Cardiopulmonary bypass (CP-bypass); Endocrinological regulation; Phenoxybenzamine (POB); Surface induced deep hypothermia combined with CP-bypass
• ISSN: 0023-1908; 1883-6135
• DOI: 10.2974/kmj1951.33.111

Hyperglycemia during and after the cardiovascular or thoracic surgery was examined from the view point of endocrinological regulation including the influence of phenoxybenzamine (POB). Sixty one patients were examined in this study. Fifty six patients who underwent open-heart surgery were divided into the following three groups; ie, i) Surface induced deep hypothermia combined with cardiopulmonary bypass (CP-bypass) (n =35), ii) CP-bypass administerd PUB (n = 13), iii) CP-bypass not administered PUB (n = 8), and the other five patients undergoing simple thoracic surgery were used as a control (the forth) group. Blood samples were taken from artery at each regular body temperapure in the deep hypothermia or at each regular time interval in the CP-bypass, respectively. Serum concentration of the following substances was measured; ie, blood sugar, NEFA, IRI, IRG, HGH, CA, Cortisol and C-peptide. 1) There was no significant difference of the basic reactive patterns between the surface-induced hypothermia and CP-bypass group, regardless of the administration of PUB. 2) Although “the suppression of insulin secretion during hypothermia or CP-bypass which was reported in the previous studies” was not seen in the present study, real secretion of insulin during hypothermia or CP-bypass was suggested to drop from the results of C-peptide secretion patterns. 3) Catecholamine secretion during open-heart surgery increased significantly compared with the control, and its increase was mainly due to the change of epinephrine. The administration of POB showed slight influence on the catecholamine secretion during CP-bypass. 4) Hyperglycemia during hypothermia or CP-bypass may be due to under-utilization of glucose and hyposecretion of insulin. However, IRG, CA and HGH also may have some effects on this phenomenon. 5) The administration of PUB during open-heart surgery was useful in an aspect of glucose metabolism.