Hospital São Rafael, Salvador, BA, Brazil.
Arq Bras Cardiol. 2011 Nov;97(5):372-9. doi: 10.1590/s0066-782x2011005000097. Epub 2011 Oct 7.
Anesthesia for pediatric cardiac surgery is systematically performed in severely ill patients under abnormal physiological conditions. In the intraoperative period, there are significant variations in blood volume, body temperature, plasma composition, and tissue blood flow, in addition to activation of inflammation, with important consequences. Serial measurements of blood glucose levels can indicate states of exacerbation of the neuroendocrine-metabolic response to trauma, serving as prognostic markers of morbidity in that population.
To correlate perioperative blood glucose levels of children undergoing cardiac surgery with the occurrence of postoperative complications, and to compare intraoperative blood glucose levels according to perioperative conditions.
Information regarding the surgical/anesthetic procedure and perioperative conditions of patients was collected from the medical records. The mean perioperative blood glucose levels in the groups of patients with and without postoperative complications and the frequencies of perioperative conditions were compared by use of odds ratio and non-parametric univariate analyses.
Higher intraoperative blood glucose levels were observed in individuals who had postoperative complications. Prematurity, age group, type of anesthesia, and character of the procedure did not influence the mean intraoperative blood glucose level. The use of extracorporeal circulation (ECC) was associated with higher blood glucose levels during surgery. In procedures with ECC, higher blood glucose levels were observed in individuals who had infectious and cardiovascular complications. In surgeries without ECC, that association was observed with infectious and hematological complications.
Higher intraoperative blood glucose levels are associated with higher morbidity in the postoperative period of pediatric cardiac surgery.
儿科心脏手术的麻醉是在异常生理条件下对重病患者进行的系统性操作。在手术期间，除了炎症的激活外，还会出现血容量、体温、血浆成分和组织血流的显著变化，这具有重要的后果。连续测量血糖水平可以指示创伤引起的神经内分泌代谢反应恶化的状态，作为该人群发病率的预后标志物。
将接受心脏手术的儿童围手术期血糖水平与术后并发症的发生相关联，并根据围手术期情况比较术中血糖水平。
从病历中收集有关手术/麻醉程序和围手术期情况的信息。通过比值比和非参数单变量分析比较有/无术后并发症的患者组的平均围手术期血糖水平和围手术期情况的频率。
在有术后并发症的患者中观察到更高的术中血糖水平。早产、年龄组、麻醉类型和手术性质并不影响术中平均血糖水平。体外循环（ECC）的使用与手术期间的血糖升高有关。在使用 ECC 的手术中，在发生感染和心血管并发症的患者中观察到更高的血糖水平。在没有 ECC 的手术中，这种关联与感染和血液学并发症有关。
术中血糖水平升高与儿科心脏手术后更高的发病率有关。
