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Endocrinologic Diseases in Pediatric Cardiac Intensive Care.

Carmen L Soto-Rivera1, Steven M Schwartz, Jaclyn E Sawyer

  • 11Department of Pediatrics, Section of Endocrinology, Harvard Medical School, Boston Children's Hospital, Boston, MA. 2Department of Pediatrics, Section of Critical Care Medicine and Cardiology, Section of Cardiac Critical Care Medicine, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada. 3Division of Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 4Pediatric Critical Care, Royal Brompton Hospital, London, United Kingdom. 5Division of Medicine Critical Care, Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, MA.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
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Summary

This review covers hyperglycemia and thyroid/adrenal issues in children undergoing cardiac surgery. Understanding these endocrine and metabolic disturbances is crucial for patient management.

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Area of Science:

  • Pediatric Endocrinology
  • Cardiovascular Surgery
  • Critical Care Medicine

Background:

  • Endocrine and metabolic dysfunctions are prevalent in critically ill children with cardiac disease.
  • Children undergoing complex congenital heart disease surgery are particularly susceptible to these issues.
  • Understanding pathophysiology, clinical impact, and treatment is vital for managing these high-risk patients.

Purpose of the Study:

  • To review the pathophysiology of hyperglycemia, and thyroid and adrenal dysfunction in pediatric cardiac surgery patients.
  • To discuss the clinical impact of these endocrine disturbances.
  • To outline current treatment strategies for these conditions.

Main Methods:

  • Literature review of MEDLINE and PubMed databases.
  • Synthesis of existing research on glucose metabolism, thyroid, and adrenal function.
  • Analysis of clinical implications and therapeutic approaches.

Main Results:

  • Hyperglycemia is a common complication.
  • Thyroid and adrenal function can be significantly altered.
  • These disturbances impact patient outcomes and recovery.

Conclusions:

  • Endocrine and metabolic disturbances are significant concerns in pediatric cardiac surgery.
  • Effective management requires a thorough understanding of the underlying pathophysiology and clinical impact.
  • Targeted treatment strategies are essential for optimizing care and improving outcomes.