SAN FRANCISCO — The longer infants experience hyperglycemia following cardiac surgery, the greater their morbidity and mortality, Dr. Andrew R. Yates reported in a poster presentation at the annual congress of the Society of Critical Care Medicine.
Infants who have hyperglycemia for 7 days or more have close to a 100% chance of morbidity and a 50%–60% chance of mortality, according to Dr. Yates and his colleagues from Ohio State University, Columbus.
Their retrospective chart review involved 184 patients younger than 1 year who underwent cardiac surgery requiring cardiopulmonary bypass. At baseline, infants who weighed less than 2 kg; those with liver or renal insufficiency, or diabetes; or those requiring extracorporeal circulation membrane oxygenation (ECMO) were excluded.
The average age of the infants was 4.3 months, and their average weight was 4.9 kg. Of the 184 patients, 21 (11.4%) died. Duration of hyperglycemia was significantly associated with liver insufficiency, renal insufficiency, infection, CNS events, the need for dialysis, the need for ECMO, and a composite measure of morbidity.
Two other measures of hyperglycemia—initial glucose level and peak glucose level—had somewhat weaker associations with various forms of morbidity. Both measures were significantly associated with the composite morbidity measure.