Pulmonary oxygen transfer deficits of diabetic origin in patients undergoing coronary artery bypass grafting.

Abstract:

:The objective of this study was to determine the effects of a diabetic disposition on pulmonary gas exchange by examining 72 patients who underwent coronary artery bypass grafting (CABG), using the arterial/alveolar oxygen tension ratio [(a/A)PO2] as a criterion. Patients were divided into a diabetic (DM) group and a nondiabetic (non-DM) group. The postoperative blood gases and hemodynamic data measured when the blood glucose level was at a maximum on the day of CABG were used as the postoperative pulmonary gas exchange indices, and the physicians who managed these patients were unaware of this study. The preoperative (a/A)PO2 ratio was 0.66 +/- 0.03 (SE) in the DM group and 0.78 +/- 0.02 in the non-DM group (P < 0.01), while the postoperative ratios were 0.42 +/- 0.03 and 0.52 +/- 0.03, respectively (P = 0.01). The correlation coefficient (r) for regression analysis of the relation between the postoperative PaO2/FIO2 ratio and the postoperative (a/A)PO2 ratio was 0.99 in the DM group (P < 0.01) and 0.88 in the non-DM group (P < 0.01). The r values of the relation between (a/A)PO2 and (A-a)PO2 were -0.68 (P < 0.00) and -0.84 (P < 0.01), while those for the respiratory index were -0.87 (P < 0.01), and -0.93 (P < 0.01), respectively. Thus, pulmonary oxygen transfer was compromised before and after CABG in the DM group compared to the non-DM group. Moreover, the PaO2/FIO2, being the simplest pulmonary gas exchange index to calculate, was a reliable substitute for the (a/A)PO2 ratio during the early postoperative management of CABG patients.

journal_name

Surg Today

journal_title

Surgery today

authors

Seki S,Yoshida H,Ooba O,Teramoto S,Komoto Y

doi

10.1007/BF00311906

subject

Has Abstract

pub_date

1993-01-01 00:00:00

pages

592-7

issue

7

eissn

0941-1291

issn

1436-2813

journal_volume

23

pub_type

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