The Association Between Prei-Operative Glucose Levels And Adverse Outcomes In Infants Receiving Open-Heart Surgery For Congenital Heart Disease With Cardiopulmonary Bypass

Objective:This retrospective study aims to explore the association between peri-operative glucose levels and adverse outcomes in infants receiving open-heart surgery for congenital heart disease with cardiopulmonary bypass (CPB).Methods:233consecutive infant patients underwent open-heart surgery with CPB from Jan2010to Dec2010were enrolled to the study.137patients were male and96patients were female with their mean age was5.0(3.0-7.0) months. Peri-operative blood glucose were measured and collected. On the basis of outcomes, we divided the patients into three groups:no-morbidity group, major morbidity group and mortality group. Patients’demographics and operation data were also collected. Binary logistic regression was used to determine the relationship between risk factors and morbidity, mortality score after controlling for multiple variables. Results:The blood glucose increased a lot at the beginning of CPB (P<0.05), and the peak128.0(109.5-156.5) mg/dl appeared after CPB.122(52.6%) infants had the complications in hospital, and20(8.6%) infants died from heart failure. Glucose at any time was not a significant factor predicting these outcomes. The RACHS-1score, surgery time, length of stay and weight were the significant predictor of major morbidity. Moreover, the independent risk factors of death in hospital were surgery time and intraoperative blood products infusion.Conclusion:In this study, peri-operative blood glucose were not risk factors for postoperative morbidity and mortality after infant receiving open-heart surgery for congenital heart disease with CPB. Whether this kind of infants need strict glycemic control is still debatable. Due to the limitations of the retrospective design of this study, more thorough clinical randomized controlled trials are needed.