Authors:T. Breuer, E. Sápi, I. L. Hartyánszky, Zs. Cserép, P. Vargha, A. Treszl, M. D. Kertai, J. Gál, M. Tóth, A. Szatmári, and Andrea Székely
Objective: To investigate the associations of blood glucose (BG) parameters and postoperative complications following paediatric cardiac surgery in the presence and absence of insulin treatment.
Methods: Prospectively collected perioperative data on 810 consecutive patients who underwent surgery for congenital heart disease were retrospectively analysed. A combined outcome of death and multiple organ dysfunction (any two of the followings: infectious, cardiac, pulmonary, renal or neurological complications) was considered as the endpoint.
Results: In total, 110 patients developed the combined endpoint and 32 of these patients died during the perioperative period. Patients treated with insulin were younger, smaller and underwent more complex procedures. They had higher peak BG levels and higher daily BG fluctuation, however, BG parameters were not associated with adverse outcome. In patients without insulin treatment, peak BG values higher than 250 mg/dl (OR, 7.65; 95% CI, 1.06–55.17; p=0.043) and BG fluctuation exceeding the level of 150 mg/dl (10.72; 1.74–65.90 p=0.010) on the first postoperative day were independently associated with the combined endpoint.
Conclusions: Peak BG level and BG fluctuation on the first postoperative day were associated with the combined endpoint of complications and death but these results were only confined to patients without insulin treatment.