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低温及体外循环下心内直视手术患儿术前、术中和术后的血糖水平及酸碱平衡(作者译)

[Blood sugar levels and acid-base balance in babies before, during and after open-heart surgery with hypothermia and extracorporeal circulation (author's transl)].

作者信息

Diggelmann U, Gattiker R

出版信息

Anaesthesist. 1976 Dec;25(12):550-4.

PMID:1008246
Abstract

New borns and babies with congenital heart disease in poor condition have been shown to have a higher risk of developing hypoglycaemia. Blood sugar levels (BSL), acid-base balance and oxygen saturation have been studies in 10 babies from 7.5 to 15 months of age, weighing less than 9kg, before, during and after open-heart surgery. Preoperative mean BSL in the anaesthetized patient was 76mg per cent. It rose slightly after the onset of surgery and further increased to an average of 205mg per cent during cardio-pulmonary bypass with the temperature stablized at 28-29 degrees C. In the early postoperative phase BSL normalized but slowly, reaching a mean value of 107mg per cent 20-24h after the end of surgery. These results demonstrate that, at least under the usual conditions of extracorporeal circulation and hypothermia at our clinic, hypoglycaemia is not a threat in babies undergoing open-heart surgery for total correction of congenital lesions. The possible mechanisms leading to the observed hyperglycaemia are discussed and the results compared with similar studies in adult patients.

摘要

研究表明,患有先天性心脏病且病情不佳的新生儿和婴儿发生低血糖的风险更高。对10名年龄在7.5至15个月、体重不足9千克的婴儿在心脏直视手术前、手术期间和手术后的血糖水平(BSL)、酸碱平衡及血氧饱和度进行了研究。麻醉患者术前平均血糖水平为每百毫升76毫克。手术开始后血糖略有上升,在心肺转流期间,温度稳定在28 - 29摄氏度时,血糖进一步升至平均每百毫升205毫克。术后早期血糖水平恢复正常,但恢复过程缓慢,在手术结束后20 - 24小时达到平均每百毫升107毫克。这些结果表明,至少在我们诊所体外循环和低温的通常条件下,低血糖并非接受先天性病变完全矫正心脏直视手术婴儿的威胁。讨论了导致观察到的高血糖的可能机制,并将结果与成年患者的类似研究进行了比较。

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