Perioperative cardiac surgical patients with high blood sugar Progress.docVIP

 PAGE \* MERGEFORMAT 27 Perioperative cardiac surgical patients with high blood sugar Progress [Keywords:] Heart Surgery; perioperative period; CPB; high blood sugar Recently it was found that CPB (cardiopulmonary bypass, CPB) and postoperative complications in patients with high blood sugar are closely related. Pathophysiology of high glucose in-depth understanding of rigorous monitoring of perioperative blood glucose levels may be useful in improving the prognosis of patients. 1 Intraoperative causes of high blood sugar 1.1 surgical trauma and stress hyperglycemia is due to surgical trauma of the stress response performance, high-heart surgery in patients with higher blood glucose levels, and the relationship between postoperative complications and mortality are more closely [1]. 1.1.1 Insulin resistance in patients with severe acute illness, trauma can lead to insulin resistance, impaired glucose tolerance and elevated blood glucose, it was called “traumatic diabetes” [2]. In this pathological state, despite the elevated blood glucose levels, increased insulin release, but the liver through gluconeogenesis can still produce too much glucose. in the liver, muscle and heart can be observed in insulin resistance, insulin activation of glucose uptake at this time was significantly reduced. IRS Insulin receptor -1-PI3K signaling pathway is inhibited, leading to abnormal glucose metabolism. compensatory increase of glucose through the insulin receptor signal transduction pathway of another (Ras-MAPK pathway) to play its role in promoting proliferation, leading to retinal neovascularization the formation of atherosclerosis and other vascular complications. under stress whether insulin resistance involving only the IRS-1-PI3K, is causing a similar vascular complications is unclear [2]. 1.1.2 The role of endocrine stress response in the sympathetic nervous system stimulant, resulting in elevated blood sugar with a variety of hormones, including cate