The effect of glucose control on clinical outcomes of correction surgery in infants with hyperglycem

来源 :South China Journal of Cardiology | 被引量 : 0次 | 上传用户:wenzl1999
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Background Currently it remains controversial whether intensive control of glucose is required for pediatric hyperglycemia. Few studies are available on the blood glucose control for the infants receiving congenital heart disease operation. However, there are no uniform standards to control hyperglycemmia after congenital heart disease operation. In this study, we determined the ranges and methods of postoperative blood glycemic control in infants with congenital heart disease. Methods Eighty-two infants younger than 6 months of age,who underwent correction of congenital heart disease in our hospital from 06/01/2014 to 06/01/2015, participated in this study. All patients were randomly divided into two groups: group A(insulin control group) and group B(non-insulin control group). Each group was randomly divided into three subgroups(A1-A3.B1-B3).Children in group A were treated using the glycemic control therapy with insulin. Children in group B received a glycemic control therapy without insulin. Femoral vein blood was drew in 72 hours after the operation to check WBC, CRP, lactate, ALT and Cr. The duration of ICU, incidence of lung infection, hypoglycemia and mortality were recorded. Results The differences of Cr ALT, WBC and CRP indexes were statistically significant(P <0.05) in A and B subgroups, but not between the A and B groups(P > 0.05). The ICU stay time of group A2 and B2 was less than that of other groups, but the difference was not statistically significant(P > 0.05). The incidence of pulmonary infection and hypoglycemia in 2 groups was lower than that in A1 and A3 group. The incidence of complications in group B2 was lower than that in B1 group and B3 group, but there was no significant difference(P > 0.05). There was no significant difference between the A and B groups(P > 0.05). Conclusions Hyperglycemia can increase postoperative pulmonary infection. Aggressive control of blood glucose does not improve patient outcomes, but increases the incidence of hypoglycemia. Background Currently it remains controversial whether intensive control of glucose is required for pediatric hyperglycemia. However, there are no uniform standards to control hyperglycemmia after congenital heart disease operation. In this study, we determined the ranges and methods of postoperative blood glycemic control in infants with congenital heart disease. Methods Eighty-two infants younger than 6 months of age, who underwent correction of congenital heart disease in our hospital from 06/01/2014 All patients were randomly divided into two groups: group A (insulin control group) and group B (non-insulin control group). Each group was randomly divided into three subgroups (A1- A3.B1-B3) .Children in group A were treated using the glycemic control therapy with insulin. Children in group B received a glycemic control therapy withou T insulin. Femoral vein blood was drew in 72 hours after the operation to check WBC, CRP, lactate, ALT and Cr. The duration of ICU, incidence of lung infection, hypoglycemia and mortality were recorded. Results The differences of Cr ALT, WBC (P <0.05) in A and B subgroups, but not between the A and B groups (P> 0.05). The ICU stay time of group A2 and B2 was less than that of other groups, but the The incidence of pulmonary infection and hypoglycemia in 2 groups was lower than that in A1 and A3 group. The incidence of complications in group B2 was lower than that in B1 group and B3 group, but There was no significant difference between the A and B groups (P> 0.05). Concressive Hyperglycemia can increase postoperative pulmonary infection. Aggressive control of blood glucose does not improve patient outcomes, but increases the incidence of hhypoglycemia.
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