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Intraoperative hyperglycemia and postoperative bacteremia in the pediatric cardiac surgery patient

James E O'Brien1, Jennifer A Marshall, Marcy L Tarrants

  • 1Cardiovascular and Thoracic Surgery Department, The Children's Mercy Hospitals and Clinics, Kansas City, Missouri 64108, USA. jobrien@cmh.edu

The Annals of Thoracic Surgery
|January 28, 2010
PubMed

Insights

Intraoperative hyperglycemia increases the risk of postoperative bacteremia in pediatric cardiac surgery patients. Blood glucose levels of 175 mg/dL or higher during cardiopulmonary bypass are significantly associated with this increased risk.

Area of Science:

  • Pediatric Cardiac Surgery
  • Infectious Disease
  • Metabolic Disorders

Background:

  • Intraoperative hyperglycemia is linked to increased postoperative infections in adult cardiac surgery.
  • The relationship between intraoperative hyperglycemia and postoperative bacteremia in pediatric cardiac surgery remains under investigation.

Purpose of the Study:

  • To determine the association between intraoperative hyperglycemia and postoperative bacteremia in pediatric cardiac surgery patients.

Main Methods:

  • Retrospective chart review of 1,132 pediatric cardiac surgical cases (patients ≤18 years) requiring cardiopulmonary bypass between June 2002 and July 2007.
  • Collected patient demographic and clinical data.
  • Performed descriptive statistics and regression analyses to assess the relationship between glucose levels and infection rates.

Main Results:

  • 1.5% (15/992 patients) developed bacteremia within 14 days of surgery.
  • A peak intraoperative glucose level of 175 mg/dL during cardiopulmonary bypass was statistically associated with a higher risk of bacteremia (p = 0.032).
  • Patients with peak glucose levels ≥175 mg/dL were over three times more likely to develop postoperative bacteremia (OR, 3.3; 95% CI, 1.04-10.39).

Conclusions:

  • Intraoperative hyperglycemia is associated with an elevated risk of postoperative bacteremia in pediatric cardiac surgery.
  • Maintaining blood glucose levels below 175 mg/dL during cardiopulmonary bypass may be crucial for reducing infection risk in this population.
Abstract

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