Masui. The Japanese journal of anesthesiology
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Using transesophageal echocardiography (TEE) we assessed left ventricular end-systolic elastance (Ees) during the pre- and post-cardiopulmonary bypass (CPB) periods in 10 patients undergoing an elective coronary artery bypass graft surgery. The end systolic volume of the left ventricle was obtained by TEE, and the end systolic pressure was obtained by the femoral artery pressure wave form. ⋯ There were no significant differences in cardiac output, ejection fraction and Ees between pre-CPB and post-CPB period. Intraoperative end-systolic pressure-volume relationship may be clinically useful to assess left ventricular function and also useful to confirm anesthetic management in patients who has undergone an coronary artery bypass graft surgery.
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We studied the blood sugar levels after hypothermic cardiopulmonary bypass (CPB) in diabetics and non-diabetics. Twenty eight patients were divided to the following four groups by the preoperative value of hemoglobin-A1c (HbA1c) and medication; (1) HbA1c < 6.0 and given oral anti-diabetic medication, (2) HbA1c > 6.0 and given oral anti-diabetic medication, (3) HbA1c > 6.0 and given insulin injection, and (4) non-diabetics. Both in diabetics and non-diabetics, the blood sugar levels were higher than 300 mg.dl-1 during cardiopulmonary bypass. ⋯ In group (2) and (3), the blood sugar levels after 60 minutes of CPB were higher than 250 mg.dl-1, and insulin 8 units were given. After 30 minutes of insulin injection, the blood sugar levels of group (2) were lower than 250 mg.dl-1, but those in group (3), the blood sugar levels were still higher than 250 mg.dl-1, and another 8 units of insulin were given. The diabetic patients whose HbA1c levels were higher than 6.0 and given anti-diabetic medication before operation, need insulin after CPB.