Paper Information

Journal:   INTERNATIONAL JOURNAL OF ENDOCRINOLOGY AND METABOLISM (IJEM)   SPRING 2013 , Volume 11 , Number 2; Page(s) 126 To 128.
 
Paper: 

CORONARY ARTERY BYPASS GRAFTING: A PRECIPITATING FACTOR FOR PERIOPERATIVE DIABETIC KETOACIDOSIS

 
 
Author(s):  SHAHRIARI ALI REZA, SINGH BAJWA SUKHMINDER JIT*, KITABCHI ABBAS
 
* DEPARTMENT OF ANAESTHESIOLOGY AND INTENSIVE CARE, GIANSAGAR MEDICAL COLLEGE AND HOSPITAL, RAM NAGAR, BANUR, PUNJAB, HOUSE NO-27-A, RATAN NAGAR, TRIPURI, PIN-147001, PATIALA, INDIA
 
Abstract: 

Non-Insulin Dependent Diabetes Mellitus (NIDDM) is a common disease entity in patients with Coronary Artery Disease (CAD). Diabetic Ketoacidosis (DKA) is not only one of the major complications of Diabetes Mellitus but also a significant challenging clinical entity for the patients undergoing any elective or emergency surgery.
Coronary Artery Bypass Grafting (CABG) being done in a patient with DKA has not been reported. We are presenting a rare case with DKA in whom CABG was carried out in a hospital devoted exclusively to cardiac cases.
Insulin was given in very large doses as a part of therapeutic regimen and the outcome was favorable. This report concludes that if a patient undergoing urgent cardiac surgery incidentally develops DKA after induction of anesthesia, then the operation can be carried out provided DKA is managed aggressively. Also, major stress factors like cardio pulmonary bypass (CPB) and hypothermia should be avoided and care should be taken to avoid cerebral edema.

 
Keyword(s): CORONARY ARTERY BYPASS GRAFTING, DIABETES MELLITUS, DIABETIC KETOACIDOSIS, INSULIN
 
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