Perioperative Hyperglycemia: Effect on Outcome After Infant Congenital Heart Surgery
| Autor: | William M. DeCampli, Hamish M. Munro, Donald E. Felix, Monica C. Olsen |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Blood Glucose
Heart Defects Congenital Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Logistic regression law.invention Postoperative Complications Risk Factors law medicine Cardiopulmonary bypass Humans Cardiac Surgical Procedures Intraoperative Complications Retrospective Studies Tetralogy of Fallot Mechanical ventilation Cardiopulmonary Bypass Receiver operating characteristic business.industry Incidence Infant Newborn Infant Perioperative medicine.disease United States Cardiac surgery Surgery Survival Rate Hyperglycemia Anesthesia Coronary care unit Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 89:181-185 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2009.08.062 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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