Perioperative hyperglycemia: effect on outcome after infant congenital heart surgery

The Annals of Thoracic Surgery
William M DeCampliDonald E Felix

Abstract

Studies demonstrate that cardiopulmonary bypass (CPB) causes intraoperative and postoperative hyperglycemia. Hyperglycemia has been associated with morbidity and mortality after infant cardiac surgery. We studied the effects on early postoperative outcomes of glucose (GLU) changes during and after pediatric cardiac surgery. The records of 144 infants less than 10 kg who underwent CPB for a variety of congenital cardiac procedures were reviewed. The GLU values (at multiple intervals during and after surgery), age, weight, CPB time, ultrafiltration volume, and risk adjustment for congenital heart surgery (RACHS-1) score were recorded. Univariate and multivariate linear and binary logistic regression were used to examine the dependence of the composite outcome mortality or postoperative infection, the mechanical ventilation time (VENT time), and the length of stay (LOS), on these variables. The RACHS-1 score was the only significant predictor of the composite variable "mortality or infection" (p = 0.008). Glucose at any time was not a significant factor predicting this outcome. Lower pre-CPB GLU, younger age, and higher RACHS-1 score were significant predictors of greater LOS and VENT time. In this study, post-CPB and postoperativ...Continue Reading

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Citations

Sep 11, 2012·The New England Journal of Medicine·Michael S D AgusUNKNOWN SPECS Study Investigators
Oct 12, 2013·Surgical Infections·Lillian S Kao, Uma R Phatak
Jan 4, 2013·British Journal of Anaesthesia·M E McCann, S G Soriano
Mar 7, 2013·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Steven M Schwartz
Jan 28, 2010·The Annals of Thoracic Surgery·James Jaggers
Apr 13, 2011·Paediatric Anaesthesia·James Steven, Susan Nicolson
Jan 27, 2015·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·J A García-HernándezJ Cano-Franco
Jul 1, 2011·World Journal for Pediatric & Congenital Heart Surgery·Steven M SchwartzJerry J Zimmerman
Sep 2, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Steven M Schwartz

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