Glucose stabilization and coronary infarction with artificial pancreas in heart-lung preparation.

In the performance of heart-lung preparations, after 4-8 hours, it is an usual feature to have multiple microinfarctions, and, finally, heart failure and ventricular fibrillation. We have studied glucose, triglycerides and conjugated fructose consumption by the heart-lung preparation and found a very fast glucose depletion (30 to 90 minutes to glucose 0, starting with glucose 120 mg/dl). The depletion has been slower for triglycerides and even slower for conjugated fructose. Ventilation with pure oxygen has not modified itself the coronary deterioration, but if a Biostator has been used in order to maintain the glucose levels at 100-110 mg/dl., the isolated heart-lung does not deteriorate in 16-24 hours, nor show electrical signs of coronary impairment; after this time, the respirator is disconnected and the preparate discarded. The above mentioned experiments demonstrated the need of artificial control of glycemia in isolated organ experiments and suggest the convenience to use more widely the artificial pancreas (Biostator in our case) for better treatment no only in diabetic or pancreatic patients, but also in many circumstances in which the glucose utilization is impaired.