Coronary Artery Bypass Grafting: A Precipitating Factor for Perioperative Diabetic Ketoacidosis

Vishal Sehgal; Sukhminder jit Singh Bajwa; Abbas Kitabchi

doi:10.5812/ijem.7183

International Journal of Endocrinology and Metabolism

Research Institute for Endocrine Sciences

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https://doi.org/10.5812/ijem.7183

Coronary Artery Bypass Grafting: A Precipitating Factor for Perioperative Diabetic Ketoacidosis

Author(s):

Vishal Sehgal¹,

Sukhminder jit Singh Bajwa^2,*,

Abbas Kitabchi³

1Regional Hospital of Scranton, The Commonwealth Medical College Scranton, PA, USA

2Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Banur, Patiala, Punjab, India, [email protected]

3Department of Medicine and Endocrinology, A202 Coleman College of Medicine Building, Court Avenue, Memphis TN, USA

International Journal of Endocrinology and Metabolism:Vol. 11, issue 2; 126-8

Published online:Mar 31, 2013

Article type:Case Report

Received:Jun 09, 2012

Accepted:Jul 15, 2012

How to Cite:Vishal Sehgal, Sukhminder jit Singh Bajwa, Abbas Kitabchi, Coronary Artery Bypass Grafting: A Precipitating Factor for Perioperative Diabetic Ketoacidosis.Int J Endocrinol Metab.2013;11(2):126-8.https://doi.org/10.5812/ijem.7183.

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.

Keywords

Coronary Artery Bypass Grafting

Diabetes Mellitus

Diabetic Ketoacidosis

Insulin

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Author(s):

Vishal Sehgal:[PubMed][Scholar]
Sukhminder jit Singh Bajwa:[PubMed][Scholar]
Abbas Kitabchi:[PubMed][Scholar]