ARTICLE INFO

Article Type

Descriptive & Survey Study

Authors

Sajadi   M. (1)
Bijari   H. (*)
Soltani   M. (2)
Kianmehr   M. (3)






(*) Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
(1) Medical-Surgical Nursing Department, Nursing & Midwifery Faculty, Gonabad University of Medical Sciences, Gonabad, Iran
(2) Anesthesiology Department, Paramedicine Faculty, Birjand University of Medical Sciences, Birjand , Iran
(3) Radiology Department, Medicine Faculty, Gonabad University of Medical Sciences, Gonabad, Iran

Correspondence

Address: Emergency Department, Vali-Asr Hospital, Ghaffari Street, Birjand, Iran
Phone: +98 (56) 32406200
Fax: -
hadi.bijari@gmail.com

Article History

Received:  March  4, 2016
Accepted:  November 12, 2016
ePublished:  January 19, 2017

BRIEF TEXT


According to the World Health Organization, diabetes is one of the serious problems in health care in the 21st century [1].

… [2-12]. One common problem after surgery is hemodynamic disturbances. Failure of complete extraction of blood and the fluid in the pericardial and pleural cavity shortly after the operation, directly or indirectly, causes numerous problems for the patients as decrease in pumping power of the heart, changes in pulse pressure, blood pressure, arrhythmia, and difficulties in breathing which in turn are followed by hemodynamic disorders after the operation in these patients [13].

This study aimed to compare the results of glucometry with venous blood sugar in diabetic patients with hemodynamic disturbances undergoing open heart surgery.

This is comparative study with a time-series design.

This study was conducted in 2015 in the heart surgery and ICU wards in Vali-e-Asr Hospital in Birjand city.

60 patients aged over 20 years who had been diagnosed as suffering from diabetes were selected by convenience sampling method. The patients were excluded from the study in case of unwillingness to participate in the study or the history of diabetes less than 5 years.

Demographic information including age, gender, weight, the age of diabetes, history of diabetes, hematocrit, blood acid uric level, blood creatinine level, history of hypertension, history of smoking, addiction, and ejection fractions were collected through a questionnaire. For capillary sampling, a glucometer (Accu-Chek Active Model manufactured by Roche, Germany) was used. Capillary blood sampling were taken four times: before surgery and at admission time to the operating room, opening time of the thorax, admission in the ICU, and an hour after admission to ICU. Then, at the same time a brachial venous blood sample were taken from elbow area by a vein needle. The venous blood samples were transferred immediately to laboratory to avoid sugar fall and the blood glucose level was measured using an enzyme kit and with help of auto analyzer machine . In order to analyze the obtained data, at first, the mean glucose levels were measured in all four times. Data was analyzed using SPSS 16 software and Pearson correlation tests, repeated measures analysis and Bland and Atman’s chart.

The mean age of all the participants was 60.00±13.70 years. Of the 60 participants, 29 (48.3%) were female and 31 (51.7%) were male (Table 1). The means of blood sugar in the two method and at different stages were significantly different that in the pairwise analysis of them, this difference was related to all stages, namely, the mean of blood sugar in each time was significantly different in the two methods (p<0.001; Table 2). According to Bland-Altman analysis, also, there was a significant difference between the two glucometry and venous methods of measuring blood sugar (Figure 1). Also strong correlation was observed between two methods of measuring blood sugar (p<0.001; r=0.94).

In condition of critical illness and rapid change of blood circulation, the difference between capillary blood sugar and venous blood sugar has increased [14, 15]. … [16-21]. Kelatehjary et al. [22], Bastanhagh et al. [23], and Fakhari and Edalati [24] found that finger capillary blood glucose and venous blood glucose are highly similar that do not match the results of this study.

It is recommended that some researches be done in relation to glucometry in the centers which use blood monitoring unit during open heart century or the centers which provide pulmonary artery catheter.

Impossibility of measuring all hemodynamic descriptive parameters of blood due to lack of renal care and facilities and equipment in the Vali-e-Asr hospital was the limitation of this study.

Although glucometry is a reliable and acceptable method for measuring blood sugar, it cannot be trusted for measuring blood sugar in patients with hemodynamic disorders; Therefore, measuring blood sugar through venous sampling within 24 hours after the operation in these patients seem more reasonable.

Spiritual and financial supports from Gonabad University of Medical Sciences are appreciated. Also, all the staff in the ICU and cardiac surgery wards in Birjand Vali-e-Asr Hospital who helped us in collecting the samples of this study and all the patients with diabetes who participated in this study are appreciated.

Non-declared

Ethical permission of this study was obtained from Ethical Committee of Gonabad University of Medical Sciences (gmu.rec. 1393.138).

This article is part of the Master’s degree thesis, appointed by Council of Graduate Studies and Research Council of Gonabad University of Medical Sciences in 2015.

TABLES and CHARTS

Show attach file


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