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Predictors of severe postoperative hyperglycemia after cardiac surgery in infants: a single-center, retrospective,

Natsuhiro Yamamoto1, Tomoya Irie2, Shunsuke Takaki3

  • 1Department of Intensive Care Unit, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan. natsuyamamo@gmail.com.

Journal of Anesthesia
|January 14, 2018
PubMed

Insights

Infants with congenital heart disease undergoing surgery are at risk for hyperglycemia. Younger age, longer cardiopulmonary bypass time, and chromosomal abnormalities predict high blood glucose levels post-surgery.

Area of Science:

  • Pediatric Cardiology
  • Critical Care Medicine
  • Neonatal Surgery

Background:

  • Hyperglycemia is common in infants post-cardiac surgery for congenital heart disease.
  • Poor glycemic control may lead to adverse postoperative outcomes.

Purpose of the Study:

  • Investigate clinical factors contributing to perioperative hyperglycemia in infants undergoing cardiac surgery.
  • Identify predictors of hyperglycemia in this vulnerable population.

Main Methods:

  • Retrospective analysis of 69 infants (1-12 months) after congenital heart disease repair with cardiopulmonary bypass (CPB).
  • Hyperglycemia defined as blood glucose ≥ 250 mg/dL on ICU admission.
  • Comparison of clinical, operative, and postoperative factors between hyperglycemic and non-hyperglycemic groups; multivariate analysis performed.

Main Results:

  • 27.5% of infants experienced hyperglycemia.
  • Hyperglycemic infants were younger, smaller, and had higher rates of chromosomal abnormalities.
  • Longer CPB and surgery times, higher peak lactate, and increased inotropic support were noted in hyperglycemic infants.
  • Hyperglycemia correlated with longer mechanical ventilation and ICU stays.

Conclusions:

  • Intraoperative hyperglycemia, longer CPB time, younger age, and chromosomal abnormalities are significant predictors of hyperglycemia at ICU admission.
  • These factors are crucial for understanding and managing glycemic control in infants post-cardiac surgery.
Abstract

Keywords:
Heart surgeryHyperglycemiaInfants

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