Background: Severe hyperglycemia was associated with adverse outcomes after cardiac surgery. Whether intraoperative and postoperative glucose concentrations equally impact outcomes were unknown. The objective of this investigation is to determine whether postoperative hyperglycemia is associated with the development of postoperative infections in the pediatric cardiac surgery patient.
Methods: One hundred seventy-nine (179) pediatric open heart surgery patients ages 19 years of age or younger, were routinely evaluated for clearance prior to operation. The practice of giving pre-operative antibiotics was also observed. By mean of finger/heel pin prick, the 1st hour glucose level, the peak glucose level and the mean glucose level were recorded in the 1st 24 postoperative hours. Clinical symptoms were evaluated. Data were gathered based on the treatment of the sepsis work up such as urine culture, blood culture and chest x-ray and clinical symptoms post-operatively.
Results: Results of the study showed that there was no significant association between postoperative hyperglycemia and postoperative infection. There was no significant difference noted in the 1st postoperative hour glucose, mean glucose level and peak glucose in the 1st 24 hours between patients with or without sepsis and overall infection. However, we did find that patients who had peak glucose level in the first 24 hours more than 176 mg/dl had greater odds to develop pneumonia (Odds ratio 2.93, p = 0.03). Also, patients with mean glucose level more than 176 mg/dl is 2.09 times higher of developing any infection (Odds ratio 2.09, p = 0.03).
Conclusion: Data from the present study does not support the need for strict glycemic control for children in the surgical intensive care unit post-cardiac surgery.