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[The changes of pancreatic function after cardiopulmonary bypass]
1Department of Cardiac Surgery, General Hospital of People's Liberation Army, Beijing 100853.
Objective:
To evaluate the changes of endocrine and exocrine pancreatic function in patients who underwent heart valve replacement under cardiopulmonary bypass (CPB) in order to optimally conside clinical management perioperatively.
Method:
Sixteen patients with heart valve disease were selected. Serum glucose, lactate, insulin, C peptide, amylase and lipase were measured.
Result:
Hyperglycemia and hyperlactacemia were noted after CPB and peaked at 19:00 on the operative day. Their changes were correctly correlated. Serum glucose and lactate returned to the baseline level on the third postoperative day. The average level of serum insulin were normal, but higher on the third postoperative day. However, the level of serum C peptide was higher than the baseline. It doubled the baseline level at 19:00 on the operative day. The average level of serum amylase and lipase was normal, except the higher level of serum lipase on the fourth postoperative day. In our group, 12 patients had normal serum amylase level perioperatively, and 4 increased serum amylase level (25%), among them 2 patients accompanied with hyperlipasimia (16%). There were 8 patients with hyperlipasimia (50%).
Conclusion:
The endocrine and exocrine pancreatic functions were influenced by CPB and did produce pathophysiologic changes.