Glycemic profile in infants who have undergone the arterial switch operation: Hyperglycemia is not associated with adverse events

Objective Tight glycemic control improves outcomes in critically ill adults. There are limited data regarding the effect of glycemic profiles in infants after cardiac operations. The aim of this study was to evaluate the association of hyperglycemia and hypoglycemia on adverse events in infants unde...

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Published inThe Journal of thoracic and cardiovascular surgery Vol. 135; no. 4; pp. 739 - 745
Main Authors Rossano, Joseph W., MD, Taylor, Michael D., MD, PhD, Smith, E. O'Brian, PhD, Fraser, Charles D., MD, McKenzie, E. Dean, MD, Price, Jack F., MD, Dickerson, Heather A., MD, Nelson, David P., MD, PhD, Mott, Antonio R., MD
Format Journal Article
LanguageEnglish
Published United States Mosby, Inc 01.04.2008
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Abstract Objective Tight glycemic control improves outcomes in critically ill adults. There are limited data regarding the effect of glycemic profiles in infants after cardiac operations. The aim of this study was to evaluate the association of hyperglycemia and hypoglycemia on adverse events in infants undergoing the arterial switch operation. Methods From 2000 through 2005, 93 infants underwent the arterial switch operation (mean age, 2.5 ± 5.9 weeks; mean weight, 3.4 ± 0.8 kg). All serum glucose values during the first 24 postoperative hours were documented. The effect of time spent in specific glycemic bands on adverse events was determined. Results Twenty-three (25%; group 1) infants spent more than 50% of the time with glucose values between 80 and 110 mg/dL, and 13 (14%; group 2) spent more than 50% of the time with glucose values of greater than 200 mg/dL. A total of 71 adverse events was documented in 45 (48%) of 93 infants. Group 1 infants were more likely to have any adverse event ( P = .001) and renal insufficiency ( P < .001). Group 2 infants were not more likely to have adverse events. When controlling for preoperative and operative factors, being in group 1 was an independent predictor of postoperative adverse events ( P = .004). Conclusion Hyperglycemia does not appear to be detrimental in postoperative infants with congenital heart disease. Infants who spent the majority of the time with glucose values between 80 and 110 mg/dL were at increased risk for adverse events. The ideal glycemic profile in the postoperative cardiac infant has yet to be defined.
AbstractList Objective Tight glycemic control improves outcomes in critically ill adults. There are limited data regarding the effect of glycemic profiles in infants after cardiac operations. The aim of this study was to evaluate the association of hyperglycemia and hypoglycemia on adverse events in infants undergoing the arterial switch operation. Methods From 2000 through 2005, 93 infants underwent the arterial switch operation (mean age, 2.5 ± 5.9 weeks; mean weight, 3.4 ± 0.8 kg). All serum glucose values during the first 24 postoperative hours were documented. The effect of time spent in specific glycemic bands on adverse events was determined. Results Twenty-three (25%; group 1) infants spent more than 50% of the time with glucose values between 80 and 110 mg/dL, and 13 (14%; group 2) spent more than 50% of the time with glucose values of greater than 200 mg/dL. A total of 71 adverse events was documented in 45 (48%) of 93 infants. Group 1 infants were more likely to have any adverse event ( P = .001) and renal insufficiency ( P < .001). Group 2 infants were not more likely to have adverse events. When controlling for preoperative and operative factors, being in group 1 was an independent predictor of postoperative adverse events ( P = .004). Conclusion Hyperglycemia does not appear to be detrimental in postoperative infants with congenital heart disease. Infants who spent the majority of the time with glucose values between 80 and 110 mg/dL were at increased risk for adverse events. The ideal glycemic profile in the postoperative cardiac infant has yet to be defined.
OBJECTIVETight glycemic control improves outcomes in critically ill adults. There are limited data regarding the effect of glycemic profiles in infants after cardiac operations. The aim of this study was to evaluate the association of hyperglycemia and hypoglycemia on adverse events in infants undergoing the arterial switch operation.METHODSFrom 2000 through 2005, 93 infants underwent the arterial switch operation (mean age, 2.5 +/- 5.9 weeks; mean weight, 3.4 +/- 0.8 kg). All serum glucose values during the first 24 postoperative hours were documented. The effect of time spent in specific glycemic bands on adverse events was determined.RESULTSTwenty-three (25%; group 1) infants spent more than 50% of the time with glucose values between 80 and 110 mg/dL, and 13 (14%; group 2) spent more than 50% of the time with glucose values of greater than 200 mg/dL. A total of 71 adverse events was documented in 45 (48%) of 93 infants. Group 1 infants were more likely to have any adverse event (P = .001) and renal insufficiency (P < .001). Group 2 infants were not more likely to have adverse events. When controlling for preoperative and operative factors, being in group 1 was an independent predictor of postoperative adverse events (P = .004).CONCLUSIONHyperglycemia does not appear to be detrimental in postoperative infants with congenital heart disease. Infants who spent the majority of the time with glucose values between 80 and 110 mg/dL were at increased risk for adverse events. The ideal glycemic profile in the postoperative cardiac infant has yet to be defined.
Tight glycemic control improves outcomes in critically ill adults. There are limited data regarding the effect of glycemic profiles in infants after cardiac operations. The aim of this study was to evaluate the association of hyperglycemia and hypoglycemia on adverse events in infants undergoing the arterial switch operation. From 2000 through 2005, 93 infants underwent the arterial switch operation (mean age, 2.5 ± 5.9 weeks; mean weight, 3.4 ± 0.8 kg). All serum glucose values during the first 24 postoperative hours were documented. The effect of time spent in specific glycemic bands on adverse events was determined. Twenty-three (25%; group 1) infants spent more than 50% of the time with glucose values between 80 and 110 mg/dL, and 13 (14%; group 2) spent more than 50% of the time with glucose values of greater than 200 mg/dL. A total of 71 adverse events was documented in 45 (48%) of 93 infants. Group 1 infants were more likely to have any adverse event ( P = .001) and renal insufficiency ( P < .001). Group 2 infants were not more likely to have adverse events. When controlling for preoperative and operative factors, being in group 1 was an independent predictor of postoperative adverse events ( P = .004). Hyperglycemia does not appear to be detrimental in postoperative infants with congenital heart disease. Infants who spent the majority of the time with glucose values between 80 and 110 mg/dL were at increased risk for adverse events. The ideal glycemic profile in the postoperative cardiac infant has yet to be defined.
Tight glycemic control improves outcomes in critically ill adults. There are limited data regarding the effect of glycemic profiles in infants after cardiac operations. The aim of this study was to evaluate the association of hyperglycemia and hypoglycemia on adverse events in infants undergoing the arterial switch operation. From 2000 through 2005, 93 infants underwent the arterial switch operation (mean age, 2.5 +/- 5.9 weeks; mean weight, 3.4 +/- 0.8 kg). All serum glucose values during the first 24 postoperative hours were documented. The effect of time spent in specific glycemic bands on adverse events was determined. Twenty-three (25%; group 1) infants spent more than 50% of the time with glucose values between 80 and 110 mg/dL, and 13 (14%; group 2) spent more than 50% of the time with glucose values of greater than 200 mg/dL. A total of 71 adverse events was documented in 45 (48%) of 93 infants. Group 1 infants were more likely to have any adverse event (P = .001) and renal insufficiency (P < .001). Group 2 infants were not more likely to have adverse events. When controlling for preoperative and operative factors, being in group 1 was an independent predictor of postoperative adverse events (P = .004). Hyperglycemia does not appear to be detrimental in postoperative infants with congenital heart disease. Infants who spent the majority of the time with glucose values between 80 and 110 mg/dL were at increased risk for adverse events. The ideal glycemic profile in the postoperative cardiac infant has yet to be defined.
Author Rossano, Joseph W., MD
Dickerson, Heather A., MD
Smith, E. O'Brian, PhD
Price, Jack F., MD
Mott, Antonio R., MD
McKenzie, E. Dean, MD
Taylor, Michael D., MD, PhD
Fraser, Charles D., MD
Nelson, David P., MD, PhD
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Issue 4
Keywords SGV
AE
serum glucose value
adverse event
CVICU
cardiovascular intensive care unit
LOS
APC
arterial switch operation
length of stay
ASO
activated protein C
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Snippet Objective Tight glycemic control improves outcomes in critically ill adults. There are limited data regarding the effect of glycemic profiles in infants after...
Tight glycemic control improves outcomes in critically ill adults. There are limited data regarding the effect of glycemic profiles in infants after cardiac...
OBJECTIVETight glycemic control improves outcomes in critically ill adults. There are limited data regarding the effect of glycemic profiles in infants after...
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StartPage 739
SubjectTerms Blood Glucose - analysis
Cardiac Surgical Procedures - adverse effects
Cardiothoracic Surgery
Female
Heart Defects, Congenital - surgery
Humans
Hyperglycemia - complications
Hypoglycemia - complications
Infant
Infant, Newborn
Male
Postoperative Period
Title Glycemic profile in infants who have undergone the arterial switch operation: Hyperglycemia is not associated with adverse events
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https://dx.doi.org/10.1016/j.jtcvs.2007.11.030
http://jtcs.ctsnetjournals.org/cgi/content/abstract/135/4/739-a
https://www.ncbi.nlm.nih.gov/pubmed/18374750
https://search.proquest.com/docview/70448344
Volume 135
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