Effect of cardiopulmonary bypass and hypothermia on pancreatic endocrine function and peripheral utilization of glucose.

Extracorporeal circulation has been reported to produce abnormalities of glucose, metabolism. Pancreatic endocrine function and peripheral glucose utilisation were studied in 11 nondiabetic patients who underwent myocardial revascularization. Nonpulsatile flow with hemodilution and moderate hypothermia to 28 degrees C were used in each case. Following the onset of cardiopulmonary bypass, serum glucose values rose rapidly to a mean of 972 mg/dl (54.0 mmol/l) and were associated with high circulating concentrations of insulin in the range of 216 microU/ml [1549.8 pmol/l]. High circulating concentrations for both insulin and glucose were maintained throughout the bypass period. These returned to normal postoperatively when the patient was in the recovery room. The results of this study indicate that both the pancreatic endocrine response and the peripheral utilization of glucose are impaired during cardiopulmonary bypass with hemodilution and moderate hypothermia to 28 degrees C.