title: Perioperative management of blood glucose during open heart surgery in infants and children.
abstract: The perioperative management of blood glucose has been controversial since clinical associations between hyperglycemia and adverse outcomes were first reported more than two decades ago. Despite some early evidence supporting a causal relationship between hyperglycemia and adverse outcomes, prospective trials of tight glycemic control have been inconclusive, except in selected populations, like adult diabetics. These trials have consistently reported dramatic increases in the incidence and severity of hypoglycemia, which may also have associated adverse outcomes. Bedside glucose monitors typically used to manage glucose have increasingly been found to introduce systematic inaccuracies. Relevant studies of infants and children undergoing cardiac surgery are considerably fewer in number, requiring clinicians to extrapolate from other clinical conditions and patient populations.
authors.affiliation: Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. steven@email.chop.edu
authors.forename: James
authors.initials: J
authors.lastname: Steven
authors.forename: Susan
authors.initials: S
authors.lastname: Nicolson
mesh_terms: D015415:Biomarkers; D001786:Blood Glucose / Q000378:metabolism*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000188:drug therapy; D007223:Infant; D007231:Infant, Newborn; D008991:Monitoring, Physiologic; D009422:Nervous System Diseases / Q000209:etiology / Q000517:prevention & control; D019990:Perioperative Care / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D005947:Glucose