After transfer to the ICU the patients were ventilated overnight with the same ventilator adjusted according to blood gas levels. Sedation consisted of subcutaneously administered morphine chlor-hydrate (0.1 mg/kg). A 10 g/L dextrose infusion was started at the arrival in the ICU at the rate of 1.25 ml/kg/h.
Pulmonary artery temperatures were measured and blood samples were drawn at the following interval times: control, 15 min after insertion of catheters (A); 5 min after tracheal intubation, before incision (B); 15 min (C) and 30 min (D) after starting CPB; at termination of CPB when cardiac mechanical activity had resumed (E); immediately (F), 1 h (G) and 3 h (H) after closure of the chest.
Arterial blood was sampled at these interval times for glucose level, (Technicon RA-100, Domont, France), acid-base status, blood gas values (alpha-stat, not corrected for patients temperature), hematocrit and plasma hormone concentrations. Blood lactate levels were measured at the onset and at the completion of CPB.
After centrifugation, the plasma was frozen at — 40°C for later assay of the following hormones: epinephrine and norepinephrine, by HPLC with electrochemical detection after extraction on alumine; insulin, cortisol and GH, by RIA according to methods previously described;” glucagon by RIA (Kit Serono-Biodata, Rome, Italy).
Glucose Homeostasis (4)