Postoperative glycemic control in pediatric cardiac surgery patients

AIM:To compare postoperative glucose levels for prediction of adverse outcomes. METHODS: One hundred and fifty-six patients undergoing open-heart surgery were randomized into groups A, B and C. Arterial blood glucose concentrations were determined every 2 h after surgery. Insulin therapy was administrated if blood glucose concentrations in groups A, B and C were >8.3 mmol/L, >10.0 mmol/L and >15.0 mmol/L, respectively. Parameters including white blood count, pulmonary infection rate, wound infection rate, hypoglycemic rate, mortality, length of ICU stay, and length of hospital stay were compared after operation. RESULTS: Hypoglycemic rate in group A was statistically higher than in groups B and C. No statistical difference was observed in white blood count, pulmonary infection rate, wound infection rate, mortality, length of ICU stay, and length of hospital stay between groups A and B. White blood count and pulmonary infection rate in group C was statistically higher than in groups A and B. CONCLUSION: Severe hyperglycemia can increase white blood count and pulmonary infection rate. Rather than improving survival and reducing morbidity, “too-tight” glycemic control increases the hypoglycemic rate.