Perioperative Hyperglycemia: Effect on Outcome After Infant Congenital Heart Surgery

    Authors

    W. M. DeCampli; M. C. Olsen; H. M. Munro;D. E. Felix

    Comments

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    Abbreviated Journal Title

    Ann. Thorac. Surg.

    Keywords

    CARDIAC-SURGERY; CARDIOPULMONARY BYPASS; PEDIATRIC-PATIENTS; GLUCOSE; HYPEROXIA; CHILDREN; Cardiac & Cardiovascular Systems; Respiratory System; Surgery

    Abstract

    Background. 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. Methods. 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. Results. 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. Conclusions. In this study, post-CPB and postoperative hyperglycemia were not risk factors for postoperative morbidity and mortality after infant cardiac surgery. (Ann Thorac Surg 2010; 89: 181-6) (C) 2010 by The Society of Thoracic Surgeons

    Journal Title

    Annals of Thoracic Surgery

    Volume

    89

    Issue/Number

    1

    Publication Date

    1-1-2010

    Document Type

    Article

    Language

    English

    First Page

    181

    Last Page

    +

    WOS Identifier

    WOS:000272939700027

    ISSN

    0003-4975

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