PMID: 9647063Jul 1, 1998Paper

Hyperglycemia during normothermic cardiopulmonary bypass: the role of the kidney

The Annals of Thoracic Surgery
H BradenM L Halperin

Abstract

Hyperglycemia commonly occurs during cardiopulmonary bypass. We studied the quantitative impact of glucose input and its renal excretion on hyperglycemia during cardiopulmonary bypass. The quantity of glucose infused and metabolite and hormone concentrations in plasma, as well as oxygen consumption, carbon dioxide production, and renal glucose excretion, were determined before, during, and after cardiopulmonary bypass in 8 patients. Hyperglycemia (14 to 29 mmol/L) was accompanied by an increase in plasma insulin levels. The degree of hyperglycemia was directly related to the amount of glucose infused. The rate of oxygen consumption did not decrease and the rate of urea appearance (gluconeogenesis) did not rise. Despite a very high filtered load of glucose, there was very little glucosuria, indicating a markedly enhanced renal absorption of glucose. Hormonal and metabolic factors permit the development of hyperglycemia during cardiopulmonary bypass but its severity depends on the quantity of glucose infused and, what appears to be a new finding, a markedly enhanced renal reabsorption of filtered glucose. Thus the kidney plays an important role in the development of severe hyperglycemia during cardiopulmonary bypass.

References

Apr 1, 1992·Physiological Reviews·R L JungasJ T Brosnan
Oct 1, 1989·Journal of Cardiothoracic Anesthesia·A V MescheryakovA A Galyibin
Dec 1, 1989·The Annals of Thoracic Surgery·H NagaokaN Funakoshi
Jul 1, 1989·The Annals of Thoracic Surgery·G S WeinsteinD H Tyras
Aug 1, 1972·The Journal of Clinical Endocrinology and Metabolism·H J RuderM B Lipsett
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Jan 1, 1993·Child Psychiatry and Human Development·E N Halperin

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Citations

Feb 2, 2010·American Journal of Surgery·Wendy F BowerC Andrew van Hasselt
Oct 24, 2007·The Annals of Thoracic Surgery·Ferenc PuskasShahar Bar-Yosef
Oct 3, 2001·The Journal of Thoracic and Cardiovascular Surgery·K S BandaliC Wittnich
Mar 31, 2007·Seminars in Thoracic and Cardiovascular Surgery·Athos J Rassias
Jul 24, 2004·Anesthesia and Analgesia·George CarvalhoThomas Schricker
Jan 10, 2009·International Anesthesiology Clinics·Sherif Afifi
Jan 19, 2010·Anesthesia and Analgesia·Shamsuddin AkhtarSilvio E Inzucchi
Apr 28, 2009·Annales Françaises D'anesthèsie Et De Rèanimation·A Ouattara

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