The effect of glucose priming solutions in diabetic patients undergoing coronary artery bypass grafting

To assess the impact of glucose-containing priming solutions on plasma glucose level in diabetic patients during and after coronary artery bypass graft surgery, we studied 50 diabetic patients and 10 nondiabetic patients who underwent bypass graft surgery. Glucose-containing priming solutions profoundly elevated plasma glucose levels during and after bypass graft surgery. In diabetic patients who received glucose primes, intraoperative peak plasma glucose levels averaged 696 +/- 48 mg/dl as compared with 341 +/- 17 mg/dl in diabetic patients who received nonglucose primes (p less than 0.001). Despite an insulin infusion, diabetic patients underwent a much slower decline in plasma glucose levels postoperatively over a 2-hour period than did nondiabetics (who did not receive an insulin infusion). We conclude that during and immediately after coronary artery bypass surgery in diabetic patients, it is desirable to avoid administration of glucose-containing priming solutions, since such solutions profoundly elevate plasma glucose levels.