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

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Abstract

Purpose

Hyperglycemia is a common issue in infants after cardiac surgery for congenital heart disease. Poor glycemic control is suspected to be associated with adverse postoperative outcomes. This study was performed to investigate clinical factors contributing to hyperglycemia in the perioperative period in infats.

Methods

A total of 69 infants (aged 1–12 months) who were admitted to Yokohama City University Hospital Intensive Care Unit (ICU) after surgical repair of congenital heart diseases with cardiopulmonary bypass (CPB) were retrospectively analysed. Hyperglycemia was defined as blood glucose ≥ 250 mg/dL on ICU admission. Clinical background, operative factors, and postoperative factors were compared between the hyperglycemic and non-hyperglycemic groups. Additionally, multivariate analysis was performed to identify factors contributing to hyperglycemia.

Results

Nineteen (27.5%) and 50 (72.5%) infants were classified into the hyperglycemic and non-hyperglycemic groups, respectively. Hyperglycemic infants were significantly younger, shorter, and weighed less, with a higher rate of chromosomal abnormalities. Intraoperatively, they also experienced longer CPB and surgery times and had higher peak lactate levels and higher inotropic requirements. Hyperglycemia was related to longer mechanical ventilation and longer ICU stays. Multivariate analysis detected intraoperative hyperglycemia, longer CPB time, younger age and chromosomal abnormality as significant factors.

Conclusion

Adding to hyperglycemia during the operation, longer CPB time younger age and chromosomal abnormality were identified as predictors of high blood glucose levels at ICU admission.

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Funding

This research was carried out without funding.

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Authors and Affiliations

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

    Natsuhiro Yamamoto, Shunsuke Takaki & Osamu Yamaguchi

  2. Department of Anesthesiology, Yokohama City University Hospital, Yokohama, Japan

    Tomoya Irie & Takahisa Goto

Authors
  1. Natsuhiro Yamamoto
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  2. Tomoya Irie
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  3. Shunsuke Takaki
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  4. Osamu Yamaguchi
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  5. Takahisa Goto
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Corresponding author

Correspondence to Natsuhiro Yamamoto.

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Ethical standards

This study was approved by Yokohama City University Ethics Committee (Number: B160101004).

Conflict of interest

No conflicts of interest declared.

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Yamamoto, N., Irie, T., Takaki, S. et al. Predictors of severe postoperative hyperglycemia after cardiac surgery in infants: a single-center, retrospective, observational study. J Anesth 32, 160–166 (2018). https://doi.org/10.1007/s00540-017-2444-x

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  • DOI: https://doi.org/10.1007/s00540-017-2444-x

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