Balanced Salt Solution in Type-2 Diabetes Mellitus undergoing Off-pump Coronary Artery Bypass Grafting: Ringer Lactate vs Plasmalyte®

Abstract

ORIGINAL RESEARCHwhere studies have reported that almost 40-50% have T2-DM. It is expected that patients undergoing OPCAB may suffer from acidosis intraoperatively as a consequence of decrease in cardiac output owing to displacement/verticalization of the heart. Uncontrolled diabetes mellitus may cause numerous physiochemical changes in the blood glucose, volume status, acid-base balance, and plasma electrolytes. Excess blood sugar IntroductIonCardiovascular disease (CVD) is a leading cause of all deaths and disability worldwide. As per the report of Global Burden of Disease in 2017, CVD caused an estimated 17.8 million deaths worldwide, corresponding to 330 million years of life lost and another 35.6 million years lived with disability. 1,2 CABG is a surgical option available for patients with significant CAD who are not suitable candidates for percutaneous interventions. CPB with cardiac arrest (on pump) provides a surgical field free of motion and blood, allowing safe anastomosis construction. Yet, the use of CPB is associated with complications peculiar to extracorporeal circulation that may be a major determinant of perioperative morbidity, hospital stay, and costs. CABG surgery on the beating heart without extracorporeal circulation (off-pump) has been successfully introduced in clinical practice. Off-pump coronary artery bypass (OPCAB) may avoid serious complications associated with CPB such as stroke, renal dysfunction, and systemic inflammatory response syndrome.Diabetes is an important cardiovascular risk factor for CAD. The prevalence of T2-DM in patients undergoing CABG surgery is nearly 30-40%. 3 This proportion is greater in India