Results
A total of 90 patients who underwent cardiac surgery at the
Cardiothoracic Surgery operating room in tertiary city hospital were
included in the study. Seven patients were not analyzed
due to lost of follow-up. NIDDM
was detected in 19 of 83 patients included and determined as group
NIDDM, the remaining non-diabetic 64 patients were determined as group
NoDM. In only 5 patients in the non-diabetic patient group, blood
glucose levels did not exceed 140 during the operation, so the rate of
stress hyperglycemia was 78%. In the NIDDM group, blood glucose levels
were high from the beginning.
Pre-operative and intra-operative demographic and clinical
characteristics of the study population are summarized in Table 1. There
were no statistically significant difference in the age, gender,
comorbidities, duration of CPB, and aortic clamping between groups
(Table 1).
The characteristics of hemodynamic and tissue oxygenation parameters
during surgery of groups were shown in Table 2.
The glucose values were
significantly different between groups. There was a statistically
significant effect of DM on blood glucose values (p<.001) as
expected. NIDDM patients had 1.67 times higher blood glucose values than
those with NoDM, (p<0.05) [95% CI: 1.47, 1.91]. In
general, time has a positive and statistically significant effect on
blood glucose levels (p<.001). As time progresses, blood sugar
increases 1.18 times (p<0.05) [95% CI: 1.17, 1.20]. When
the change in the blood glucose values of the patients in the NIDDM and
NoDM groups is examined, the blood glucose levels of the patients with
NIDDM increase 0.879 times as time progresses, while the patients with
NoDM increase 1/0.879=1.14 times as time progresses (Figure 1).
Hypoglycemic attack was not observed in any patient.
The O2ER values were significantly different between
groups when repeated measurements were analyzed together with GEE method
(p=0.004) (Figure 2). There is a statistically significant difference
between the groups at the 4th time point (p=0.022).
Patients in the NIDDM group had higher O2ER values than
patients in the NoDM group at time points 1, 2, and 4. NIDDM patients
had 1.22 times higher O2ER values than those with NoDM,
and this result was statistically significant [95% CI: 1.06-1.40].
There was no statistically significant effect of time on
O2ER values (p=0.746).
There was no statistically significant effect of blood glucose values on
O2ER (p=0.549), and also no statistically significant
effect of O2ER values on blood glucose was found
(p=0.578).
There was no statistically difference at lactate level,
DO2, VO2, SVR, ScvO2,
Hb, MAP, HR, temperature, and urine output values between groups.
Intraoperative inotropic medications, blood product transfusion rates,
postoperative complications, and mortality data were not statistically
different as shown in Table 3.