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Perioperative blood glucose variability and autonomic nervous system activity in on-pump cardiac surgery patients:

Etienne Chazal1, Anne-Laure Parmentier2, Sebastien Pili-Floury1

  • 1Department of Anesthesiology and Intensive Care Medicine, University Hospital of Besancon, and EA 3920, University of Franche-Comte, Besancon, France.

Medicine
|December 1, 2022
PubMed

Insights

Perioperative blood glucose (BG) variability in high-risk surgeries may be linked to autonomic nervous system (ANS) activity. Understanding this connection can improve patient outcomes after cardiac procedures.

Area of Science:

  • Cardiology
  • Endocrinology
  • Neurosurgery

Background:

  • On-pump coronary artery bypass graft (CABG) and surgical valve replacement (SVR) are high-risk procedures associated with significant perioperative blood glucose (BG) variability.
  • Existing research indicates a correlation between BG variability and adverse postoperative outcomes, but the underlying mechanisms remain unclear.

Purpose of the Study:

  • To investigate the relationship between preoperative BG variability and postoperative BG variability.
  • To explore the association between autonomic nervous system (ANS) activity and BG variability during the perioperative period.
  • To examine how diabetes phenotype and surgical type influence BG variability and its relationship with ANS activity and biomarkers.

Main Methods:

  • Prospective observational single-center study involving four patient groups (diabetic and non-diabetic undergoing CABG or SVR).
  • Continuous subcutaneous BG monitoring using Abbott's Freestyle Libre Pro sensor for assessing BG variability.
  • Noninvasive continuous heart rate monitoring (Mooky HR memory®) to measure ANS activity.
  • Analysis of blood and urinary biomarkers for inflammatory and endothelial dysfunction.

Main Results:

  • The study aims to describe the relationship between baseline and postoperative BG variability.
  • Secondary objectives include analyzing these relationships based on diabetes status and surgical procedure.
  • Further analysis will focus on the correlation between ANS activity, BG variability, and specific biomarkers.

Conclusions:

  • This study hypothesizes that perioperative BG variability is linked to alterations in ANS activity and preoperative BG patterns.
  • Findings are expected to elucidate mechanisms contributing to BG variability and its impact on patient outcomes.
  • Results may inform strategies for managing BG variability in high-risk cardiac surgery patients.
Abstract

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