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International Journal of Endocrinology and Metabolism
Research Institute for Endocrine Sciences
e-ISSN 1726-9148
p-ISSN 1726-913X
Coronary Artery Bypass Grafting: A Precipitating Factor for Perioperative Diabetic Ketoacidosis
Authors
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, sukhminder_bajwa2001@yahoo.com
3Department of Medicine and Endocrinology, A202 Coleman College of Medicine Building, Court Avenue, Memphis TN, USA
*Corresponding Author: Sukhminder jit Singh Bajwa, 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, sukhminder_bajwa2001@yahoo.com. Tel: +99-15025828. Fax: +91-1752352182. Email: sukhminder_bajwa2001@yahoo.com
Published online:Mar 31, 2013
Article type:Case Report
Received:Jun 09, 2012
Accepted:Jul 15, 2012
How to Cite:Sehgal V, Bajwa SJS, Kitabchi A. Coronary Artery Bypass Grafting: A Precipitating Factor for Perioperative Diabetic Ketoacidosis. Int J Endocrinol Metab. 2013;11(2):. doi: 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.
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Copyright
© 2013, Author(s). This open-access article is available under the Creative Commons Attribution 4.0 (CC BY 4.0) International License (https://creativecommons.org/licenses/by/4.0/), which allows for unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.
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