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2017, Number 3

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Rev Med Inst Mex Seguro Soc 2017; 55 (3)

Prognostic factors of postoperative severe hyperglycemia after cardiac surgery in pediatric patients

Marín-Vivas RR, Saldívar-Müller CE, Sánchez-Bañuelos CC, Flores-Lujano J, Núñez-Enríquez JC

Language: Spanish
References: 17
Page: 324-329
PDF size: 287.97 Kb.


ABSTRACT

Background: Patients who underwent surgery for congenital heart disease requiring cardiopulmonary bypass (CPB) have metabolic complications, like hyperglycemia, which is associated to a greater postoperative morbidity and mortality. Our objective was to identify predictors of severe postoperative hyperglycemia (≥ 200 mg/dL) in pediatric patients after cardiopulmonary bypass.
Methods: A case-control study was conducted from January 1 to December 31, 2014. We included all pediatric patients undergoing cardiac surgery attended at postoperative care in a pediatric intensive care unit from a third level hospital. The dependent variable was severe postoperative hyperglycemia (≥ 200 mg/dL). An unconditional logistic regression analysis was performed and confidence intervals of 95% (95% CI) were calculated to identify the most important and independent predictors associated with severe postoperative hyperglycemia.
Results: The frequency of severe postoperative hyperglycemia in our sample was 45.9%, being the most important and independent predictors the cyanotic heart disease (p = 0.04), postoperative serum lactate levels of more than 3 mmol/L (p = 0.001) and a level of deep hypothermia (‹ 25 °C) during perfusion (p = 0.01). The frequency of severe postoperative hyperglycemia was high in the studied population.
Conclusions: It is important to carry out systematic monitoring of postoperative blood glucose in order to timely detect and treat these patients


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