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Abstract

BACKGROUND:

Hyperglycemia after cardiac-valve replacement can happen easily that is unfavorable on the prognosis. However, the perioperative blood glucose has close relationship with the level of lactic acid in patients.

OBJECTIVE:

To observe the changes of blood glucose and blood lactic acid levels in the patients with cardiac-valve replacement, and to perform the correlation analysis.

METHODS:

Sixty-three patients with cardiac-valve replacement were randomly divided into two groups. The control group received traditional standard therapy, and the blood glucose concentration was maintained at 7.5-11.1 mmol/L. The experimental group received intensive therapy by subcutaneous infusion or continuous insulin infusion, and the blood glucose concentration was maintained at 3.6-7.5 mmol/L.

RESULTS AND CONCLUSION:

The concentration of blood glucose during cardiopulmonary bypass and after valve replacement in experimental group was lower than that in the control group (P < 0.05); with the time of the cardiac-valve replacement increased, the blood lactic acid levels of two groups were significantly increased, and the hyperlactacidemia could be seen, the incidence of complications in the experimental group was lower than that in the control group (P < 0.05). The blood glucose and blood lactic acid levels in two groups were gradually increased and returned to the normal levels, the blood glucose and blood lactic acid levels were highest at 6 hours after replacement. The changes of blood glucose level and blood lactic acid level were the same. One variant linear regression analysis showed the correlation coefficient of blood glucose and lactic acid was 0.838 and P < 0.01 in one side, which proved that there was a linear relationship between the two variables. Strict application of insulin is beneficial to the control intraoperative and postoperative blood glucose and blood lactic acid levels of cardiac-valve replacement and can reduce the incidence of complication after replacement. Perioperative blood glucose and blood lactic acid levels are positively correlated.

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