%0 Journal Article
%T Resultados cl¨ªnicos e metab¨®licos da abrevia£¿£¿o do jejum com carboidratos na revasculariza£¿£¿o cir¨²rgica do mioc¨¢rdio
%A Feguri
%A Gibran Roder
%A Lima
%A Paulo Ruiz L¨²cio
%A Lopes
%A Andr¨¦a Mazoni
%A Roledo
%A Andr¨¦a
%A Marchese
%A Miriam
%A Trevisan
%A M£¿nica
%A Ahmad
%A Haitham
%A Freitas
%A Bruno Baranhuk de
%A Aguilar-Nascimento
%A Jos¨¦ Eduardo de
%J Revista Brasileira de Cirurgia Cardiovascular
%D 2012
%I Sociedade Brasileira de Cirurgia Cardiovascular
%R 10.5935/1678-9741.20120004
%X introduction: limited information is available about preoperative fasting abbreviation with administration of liquid enriched with carbohydrates (cho) in cardiovascular surgeries. objectives: to evaluate clinical variables, security of the method and effects on the metabolism of patients undergoing fasting abbreviation in coronary artery bypass graft (cabg) surgery. methods: forty patients undergoing cabg were randomized to receive 400 ml (6 hours before) and 200 ml (2 hours before) of maltodextrin at 12.5% (group i, n=20) or just water (group ii, n=20) before anesthetic induction. perioperative clinical variables were evaluated. insulin resistance (ir) was evaluated by homa-ir index and also by the need of exogenous insulin; pancreatic beta-cell excretory function by homa-beta index and glycemic control by tests of capillary glucose. results: deaths, bronchoaspiration, mediastinitis, stroke and acute myocardial infarction did not occur. atrial fibrillation occurred in two patients of each group and infectious complications did not differ among groups (p=0.611). patients of group i presented two days less of hospital stay (p=0.025) and one day less in the icu (p<0.001). the length of time using dobutamine was shorter in group i (p=0.034). glycemic control in the first 6h after surgery was worse for group ii (p=0.012). ir was verified and did not differ among groups (p>0.05). a decline in the endogenous production of insulin was observed in both groups (p<0.001). conclusion: preoperative fasting abbreviation with the administration of cho in the cabg was safe. the glycemic control improved in the icu; there was less time in the use of dobutamine and length of hospital and icu stay was reduced. however, neither ir nor morbimortality during hospital phase were influenced.
%K myocardial revascularization
%K perioperative care
%K insulin resistance
%K metabolism
%K fasting.
%U http://www.scielo.br/scielo.php?script=sci_abstract&pid=S0102-76382012000100004&lng=en&nrm=iso&tlng=en