The aim of this prospective study was to determine whether the preoperative oral intake of carbohydrate-rich drinks by patients undergoing a coronary artery bypass graft attenuates postoperative insulin requirements, improves postoperative patient discomfort, provides inotropic support, shortens the length of the ICU stay, and shortens the duration of postoperative mechanical ventilation.
Materials and methods:This randomized prospective clinical study included 152 patients with coronary artery disease who were divided into 4 groups. Carbohydrates were administered to 3 groups at different hours and doses before operation. The fourth group had an 8-h preoperative fasting period. The inotropic and vasopressor requirements, ventilation time, and ICU stay time were recorded for all of the groups. Patient wellbeing, mouth dryness, hunger, anxiety, and nausea were assessed using VAS scores of 1-10.Results: Mouth dryness and hunger were significantly higher in the control group (P = 0.03, P = 0.02). The increase in blood glucose level was significantly higher in the control group (P = 0.04). The exogenous insulin requirement was significantly higher in the control group than in the other groups (P = 0.04).
Conclusion:The administration of carbohydrates before elective cardiac surgery reduced insulin resistance. Based on the VAS scores, the intake of carbohydrates reduced mouth dryness and hunger. Overall, preoperative oral carbohydrate treatments can improve the postoperative outcomes of coronary artery bypass graft surgeries.
Introduction
We aimed to investigate whether vasoactive-inotropic score (VIS) is a predictor for early postoperative morbidity and mortality.
Methods
This study was planned as a prospective cohort study, between Nov 20 2018 and May 15 2019, including a total of 290 patients aged 20 years or older who underwent elective on-pump coronary artery bypass grafting (CABG). Patients’ demographic data, aortic cross-clamp and cardiopulmonary bypass times, European System for Cardiac Operative Risk Evaluation (EuroSCORE) score, cardiac ejection fraction (EF), VIS, intubation duration, and intensive care unit length of stay were recorded. Postoperative mortality and morbidity were recorded. Hourly doses of inotropes for VIS were recorded for each patient, and VIS was calculated.
Results
Among the cases, 222 (77%) were male and 68 (23%) were female. The mean age of our patients was 62.5 years (37-86). Combined morbidity and mortality rates of our patients were 23.8%. An optimal cutoff point for VIS of 5.5 could predict combined morbidity and mortality with 90% sensitivity and 88% specificity. Low EF, prolonged operation time, high EuroSCORE, and high VIS are independent factors in the early postoperative period for the development of combined morbidity and mortality in patients who underwent elective CABG.
Conclusion
VIS is the most critical and EuroSCORE is the second most important scoring systems. They independently predict combined morbidity and mortality in undergoing elective coronary artery bypass surgery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.