• J. Cardiothorac. Vasc. Anesth. · Nov 2023

    Randomized Controlled Trial

    Efficacy of Perioperative Infusion of N(2)-L-alanyl-L-glutamine in Glycemic Control for Patients With Uncontrolled Diabetes Mellitus Presented for Urgent Coronary Artery Bypass Surgery: A Randomized Controlled Trial.

    • Aya Hisham Moussa Ahmad, Farouk Kamal Eldin, and Mohamed Mohsen Rashed.
    • Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: ayahisham@med.asu.edu.eg.
    • J. Cardiothorac. Vasc. Anesth. 2023 Nov 1; 37 (11): 228922982289-2298.

    ObjectivesTo evaluate the efficacy of preoperative glutamine infusion in reducing insulin requirements in patients with uncontrolled type 2 diabetes, defined as glycated hemoglobin (HbA1c) >7%, undergoing urgent coronary artery bypass graft (CABG) surgery.DesignA randomized controlled trial.SettingAt Ain Shams University Hospital, Cardiothoracic Academy.ParticipantsNinety-three patients (of both sexes) with uncontrolled diabetes presenting for urgent CABG were categorized into 2 groups.InterventionsThe dipeptiven group (n = 46) was given an infusion of dipeptiven 1.5 mL/kg body weight dissolved in normal saline (200 mL) over 3 hours before surgery. The control group (n = 47) received a normal saline infusion (200 mL).Measurements And Main ResultsThe dipeptiven group demonstrated statistically significant lower intraoperative (173.74 ± 19.97 mg/dL v 198.22 ±14.64 mg/dL) and postoperative (162.36 ±13.11 mg/dL v 176.13 ±14.86 mg/dL) mean blood glucose levels. In addition, dipeptiven infusion was found to reduce mean total insulin requirements intraoperatively by 3.64 ± 0.56 units/h and postoperatively by 37.109 ± 4.30 units/24 h in comparison to placebo (50.98 ± 16.55 units/24 h and 5.10 ± 2.28 units/h, respectively).ConclusionA preoperative infusion of dipeptiven can contribute to ameliorating stress hyperglycemia in uncontrolled diabetic patients undergoing urgent CABG.Copyright © 2023 Elsevier Inc. All rights reserved.

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