Hyperglycemia is a marker for poor outcome in the postoperative pediatric cardiac patient.
OBJECTIVE
Hyperglycemia in critical care populations has been shown to be a risk factor for increased morbidity and mortality. Minimal data exist in postoperative pediatric cardiac patients. The goal of this study was to determine whether hyperglycemia in the postoperative period was associated with increased morbidity or mortality.


METHODS
Retrospective chart review.


METHODS
Tertiary care, free-standing pediatric medical center with a dedicated cardiac intensive care unit.


METHODS
We included 184 patients <1 yr of age who underwent cardiac surgery requiring cardiopulmonary bypass from October 2002 to August 2004. Patients with a weight <2 kg, a preoperative diagnosis of diabetes, preoperative extracorporeal membrane oxygenation support, solid organ transplant recipients, and preoperative renal or liver insufficiency were excluded.


METHODS
None.


RESULTS
Age was 4.3 +/- 3.2 months and weight was 4.9 +/- 1.7 kg at surgery. Duration of hyperglycemia was significantly longer in patients with renal insufficiency (p = .029), liver insufficiency (p = .006), infection (p < .002), central nervous system event (p = .038), extracorporeal membrane oxygenation use (p < .001), and death (p < .002). Duration of hyperglycemia was also significantly associated with increased intensive care (p < .001) and hospital (p < .001) stay and longer ventilator use (p < .001). Peak glucose levels were significantly different in patients with renal insufficiency (p < .001), infection (p = .002), central nervous system event (p = .01), and mortality (p < .001).


CONCLUSIONS
Hyperglycemia in the postoperative period was associated with increased morbidity and mortality in postoperative pediatric cardiac patient. Strict glycemic control may improve outcomes in this patient population.
Yates
Andrew R
AR
Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43205-2696, USA. yatesa@pediatrics.ohio-state.edu
Dyke
Peter C
PC
Taeed
Roozbeh
R
Hoffman
Timothy M
TM
Hayes
John
J
Feltes
Timothy F
TF
Cua
Clifford L
CL
D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009820:Ohio / Q000453:epidemiology; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D012189:Retrospective Studies; D012306:Risk; D018570:Risk Assessment