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Hypoglycemic coma after cardiac surgery.

A Criado, E Dominguez, J Carmona

    Critical Care Medicine
    |April 1, 1984
    PubMed
    Summary
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    A non-diabetic patient experienced hypoglycemic coma post-cardiac surgery due to low cardiac output and metabolic issues. Glucose infusion improved both blood sugar and heart function.

    Area of Science:

    • Cardiology
    • Endocrinology
    • Anesthesiology

    Background:

    • Cardiac surgery can lead to complex metabolic disturbances.
    • Postoperative hypoglycemia is a rare but serious complication, even in non-diabetic patients.

    Observation:

    • A non-diabetic adult patient developed hypoglycemic coma 5 hours after cardiac surgery.
    • The patient presented with low cardiac output, hepatic dysfunction, and metabolic acidosis.
    • Fentanyl anesthesia may have inhibited the adrenergic response.

    Findings:

    • Hypoglycemic coma was primarily triggered by low cardiac output causing hepatic derangement and metabolic acidosis from hypoperfusion.
    • Glucose infusion at 8 g/h normalized blood glucose levels.
    • Hemodynamic parameters improved concurrently with glucose infusion.

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    Implications:

    • This case highlights the importance of monitoring glucose levels in non-diabetic patients after cardiac surgery.
    • Understanding the interplay between cardiac function, metabolism, and anesthesia is crucial for managing postoperative complications.
    • Early glucose management can aid hemodynamic recovery in critical surgical patients.