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Perioperative hyperglycemia: effect on outcome after infant congenital heart surgery

William M DeCampli1, Monica C Olsen, Hamish M Munro

  • 1Congenital Heart Institute, Arnold Palmer Hospital for Children, Orlando, Florida 32806, USA. william.decampli@orlandohealth.com

The Annals of Thoracic Surgery
|January 28, 2010
PubMed

Insights

Hyperglycemia (high blood sugar) after infant heart surgery does not increase mortality or infection risk. Other factors like age and surgical complexity predict longer recovery times.

Area of Science:

  • Pediatric Cardiac Surgery
  • Intensive Care Medicine
  • Metabolic Disorders

Background:

  • Cardiopulmonary bypass (CPB) is known to cause hyperglycemia (high blood glucose) during and after surgery.
  • Hyperglycemia is a potential risk factor for adverse outcomes, including mortality, in infants undergoing cardiac surgery.

Purpose of the Study:

  • To investigate the impact of glucose (GLU) levels during and after pediatric cardiac surgery on early postoperative outcomes.
  • To determine if hyperglycemia is a significant predictor of morbidity and mortality in this patient population.

Main Methods:

  • Retrospective review of 144 infants (<10 kg) undergoing CPB for congenital cardiac procedures.
  • Analysis of glucose levels, age, weight, CPB duration, ultrafiltration, and RACHS-1 score.
  • Univariate and multivariate regression models to assess predictors of mortality, infection, ventilation time, and length of stay.

Main Results:

  • The Risk Adjustment for Congenital Heart Surgery (RACHS-1) score was the sole significant predictor of mortality or postoperative infection.
  • Glucose levels at any time point were not significant predictors of mortality or infection.
  • Lower pre-CPB glucose, younger age, and higher RACHS-1 scores predicted longer mechanical ventilation time and hospital length of stay.

Conclusions:

  • Postoperative hyperglycemia was not identified as a risk factor for morbidity or mortality in infants following cardiac surgery.
  • Surgical complexity (RACHS-1 score), patient age, and pre-operative glucose levels are more significant factors influencing recovery outcomes.
Abstract

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