[Background]
Hyperglycemia in infants after cardiac surgery for congenital heart disease is a common issue. Poor glycemic control is reported to be associated with adverse postoperative outcomes such as longer hospital stay and higher mortality, but conflicting study also exists. This study is aimed to investigate clinical factors contributing to hyperglycemia in perioperative period.
[Methods]
We performed a single centre retrospective cohort study. From January 2012 to November 2015, 48 infants (aged 1 to 12 months) underwent cardiac surgery with cardiopulmonary bypass (CPB). We defined hyperlgycemic group as blood glucose ≧ 250 mg/dl at ICU admission. Clinical background, operative factors and postoperative factors were compared between hyperglycemic group and euglycemic group. Data are presented as mean ± SD, and comparison was made by unpaired t test. Addtionally, multivariable analysis was performed to find factors that influences hyperglycemia.
[Results and Discussion]
In 48 patients, the number of hyperglycemic group was 13 (27.1%) and of euglycemic group was 35 (72.9%). Hyperglycemic group showed significantly smaller body weight (4.4 ± 3.5 vs 6.4 ± 2.7 kg), higher rate of chromosomal abnormality (46.2 ± 3.8 vs 14.3± 1.0 %), longer CPB time (5.5 ± 1.5 vs 2.4 ± 1.0 hour), higher peak lactate level (3.3 ± 0.9 vs 2.4 ± 0.8 mmol/L) and higher catecholamine index (11.3 ± 5.1 vs 4.5 ± 2.2). Glucose intake and methylprednisolone dose during operation were not different between two groups. Multivariable analysis revealed chromosomal abnormality, peak lactate level and catecholamine index were predictive factors of hyperglycemia. Hyperglycemia was significantly associated with longer postoperative mechanical ventilation (3.2± 1.2 vs 1.4 ± 1.3 days).
[Conclusion]
Higher catecholamine dose, higher lactate level, longer CPB time, smaller body weight and chromosomal abnormality were detected as predictors of high blood glucose at ICU admission. Hyperglycemia was shown to be associated with longer mechanical ventilation time.

Predictors of postoperative hyperglycemia after paediatric cardiac surgery - a single centre retrospective cohort study