Cardiothoracic & vascular anesthesia
Metabolic acidosis in patients with diabetes 2 undergoing cardiac surgery: The impact of SGLT2 inhibitor use: a retrospective cohort study
Authors' conclusion
While taking SGLT2 inhibitors, diabetic patients undergoing heart surgery are at an increased risk of ketosis and possibly metabolic acidosis.
Study context
- Population
- Patients with type 2 diabetes undergoing cardiac surgery, tertiary regional hospital in Western Norway, 2-year period
- Participants
- 121 patients
- Exposure
- SGLT2-i use vs no SGLT2-i use
- SGLT2-in = 38
- Controln = 83reference
- Outcome
- Base excess and anion gap as indicators of ketosis development
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Base excess and anion gap
- Anion gap elevated in the SGLT2-i group vs control at 12 h postoperatively
- P = 0.018
- SGLT2-i use independently associated with lower lactate-corrected base excess (multivariable regression)
- P < 0.001
Observational data: associations, not effects.
Further findings
Base excess −3 mmol l −1 or less after lactate correction (ketosis), patients without renal failure (GFR > 60) (subgroup) · 12 h postoperatively
P < 0.001
Serum lactate
- No significant differences between groups
SGLT2-i cessation
- Cessation of SGLT2-i did not correlate with the degree of acidosis
Original publication
Metabolic acidosis in patients with diabetes 2 undergoing cardiac surgery: The impact of SGLT2 inhibitor use: a retrospective cohort study. Eur J Anaesthesiol. Published 24 October 2024. doi:10.
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