Abstracts of the 22nd Annual Meeting of the European Association of Cardiothoracic Anaesthesiologists.

Abstract

Silesian Centre for Heart Diseases, Zabrze, Poland Introduction: Diabetic patients have poorer short-term outcome after coronary artery surgery [1]. It has been suggested that preoperative HbA1c may predict length of stay in such patients [2]. The aim of this study was to find out the impact of long-term glycaemic control expressed by preoperative HbA1c on perioperative outcome in diabetic patients following coronary artery surgery. Method: 145 consecutive diabetic patients underwent first-time coronary artery surgery in a period of 11 months and had their HbA1c assessed Results: Fifty-nine percent of the patients had low plasma AT III levels before CPB (levels 80%). Of these, 64% required the administration of AT III concentrate for correct anticoagulation to be attained, since the mean ACT after the first dose of heparin was 404 seconds. In 37.5% of the cases, the patients received 500 U of AT III; 12.5% 750 U of AT III, and 50% 1000 U of AT III. Conclusions: We consider that a low pre-operative plasma AT III level predicts and an ACT value lower than 480 seconds after heparin indicates resistance to heparin and the need to administer AT III concentrate to achieve correct anticoagulation during CPB. The optimum dose of AT III concentrate in cases of heparin resistance is 1000 U.