Effect of insulin-targeted glucose therapy on hemodynamics and cardiac function in organ donors
10.3760/cma.j.cn421203-20210519-00151
- VernacularTitle:胰岛素强化血糖管理对器官捐献者循环及心功能的影响
- Author:
Xiaojing DOU
1
;
Qingping WANG
;
Weiye ZHANG
;
Jinshan WANG
;
Yiqi WENG
;
Wenli YU
Author Information
1. 天津市第一中心医院麻醉科，天津 300192
- Keywords:
Organ donation;
Insulin;
Blood glucose
- From:
Chinese Journal of Organ Transplantation
2022;43(3):156-160
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of intensive insulin therapy on hemodynamics and cardiac function in organ donors.Methods:A total of 60 organ donors were randomly divided into two groups of intensive insulin therapy(IIT)and control(30cases each group). Blood glucose was adjusted at 6.2~10.0 mmol/L in control group and 4.4~6.1 mmol/L in IIT group.Blood glucose and insulin dosage during maintenance were recorded.Cardiac function values as well as serum inflammatory factor concentrations at admission and during donation were compared between two groups.Results:During maintenance, blood glucose was significantly lower in IIT group than that in control group [(5.1±0.6)vs(8.2±1.5)mmol/L, P<0.05] and insulin dosage was higher than that in control group [(9.5±3.2)vs(5.8±1.5)U/h, P<0.05]. As compared with control group, cardiac cycle efficiency(CCE), maximal rate of elevated pressure(DP/DT max)and left ventricular ejection fraction(LVEF)in were significantly higher in IIT group than those of control group.And serum cardiac troponin I(cTnI), N-terminal B-type natriuretic peptide(NT-Pro-BNP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and high mobility group box-1 protein(HMGB1)as well as vasoactive-inotropic score(VIS)were significantly lower than those in control group( P<0.05). As compared with control group, cardiac donation rate of IIT group was significantly higher(30% vs 16.7%, P<0.05). Conclusions:Intensive insulin therapy and blood glucose control may blunt inflammatory response in organ donors, lessen myocardial injury and myocardial depression, stabilize hemodynamics and boost the rate of cardiac donation.
