title: Perioperative blood glucose level and postoperative complications in pediatric cardiac surgery.
abstract: BACKGROUND
  Anesthesia for pediatric cardiac surgery is systematically performed in severely ill patients under abnormal physiological conditions. In the intraoperative period, there are significant variations in blood volume, body temperature, plasma composition, and tissue blood flow, in addition to activation of inflammation, with important consequences. Serial measurements of blood glucose levels can indicate states of exacerbation of the neuroendocrine-metabolic response to trauma, serving as prognostic markers of morbidity in that population.
  
  
  OBJECTIVE
  To correlate perioperative blood glucose levels of children undergoing cardiac surgery with the occurrence of postoperative complications, and to compare intraoperative blood glucose levels according to perioperative conditions.
  
  
  METHODS
  Information regarding the surgical/anesthetic procedure and perioperative conditions of patients was collected from the medical records. The mean perioperative blood glucose levels in the groups of patients with and without postoperative complications and the frequencies of perioperative conditions were compared by use of odds ratio and non-parametric univariate analyses.
  
  
  RESULTS
  Higher intraoperative blood glucose levels were observed in individuals who had postoperative complications. Prematurity, age group, type of anesthesia, and character of the procedure did not influence the mean intraoperative blood glucose level. The use of extracorporeal circulation (ECC) was associated with higher blood glucose levels during surgery. In procedures with ECC, higher blood glucose levels were observed in individuals who had infectious and cardiovascular complications. In surgeries without ECC, that association was observed with infectious and hematological complications.
  
  
  CONCLUSIONS
  Higher intraoperative blood glucose levels are associated with higher morbidity in the postoperative period of pediatric cardiac surgery.
authors.affiliation: Hospital São Rafael, Salvador, BA, Brazil. peres@mail.com
authors.forename: Rodrigo Leal
authors.initials: RL
authors.lastname: Alves
authors.forename: Macius Pontes
authors.initials: MP
authors.lastname: Cerqueira
authors.forename: Nadja Cecília de Castro
authors.initials: NC
authors.lastname: Kraychete
authors.forename: Guilherme Oliveira
authors.initials: GO
authors.lastname: Campos
authors.forename: Marcelo de Jesus
authors.initials: Mde J
authors.lastname: Martins
authors.forename: Norma Sueli Pinheiro
authors.initials: NS
authors.lastname: Módolo
mesh_terms: D000293:Adolescent; D000758:Anesthesia / Q000009:adverse effects / Q000145:classification; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005112:Extracorporeal Circulation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007432:Intraoperative Period; D008297:Male; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology*; D011379:Prognosis
chemical_list: D015415:Biomarkers; D001786:Blood Glucose