What is the clinical evidence from this study?

Study design: Editorial. Population: Neonatal heart surgery (n=171). Intervention: Hyperglycemia vs. Normal or low glucose levels. Primary outcome: Early or late neurologic or developmental outcome.

May 19, 2004AnesthesiologyOpen Access

Glucose and Heart Surgery: Neonates Are Not Just Small Adults

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Key result

High blood glucose levels during neonatal heart surgery were not associated with poor early or late neurologic or developmental outcomes.

Why the study?

Does hyperglycemia worsen neurologic and developmental outcomes in neonates undergoing heart surgery?

Structured PICO

Does hyperglycemia worsen neurologic and developmental outcomes in neonates undergoing heart surgery?

Population

171 neonates undergoing the arterial switch operation for D-transposition of the great arteries, with neurologic and developmental evaluations at 1, 4, and 8 years of age.

Exposure

High serum glucose levels (hyperglycemia, defined as >150 mg/dl)

Comparator

Normal or low serum glucose levels

Outcome

Neurologic and developmental outcome at 1, 4, and 8 years of age, and continuous electroencephalogram monitoring

Limitations

Observational and not originally designed to address the impact of glucose management on neurologic outcome
Weak correlation coefficients for the return of electroencephalogram activity
Uncertain relationship between return of electroencephalogram activity and neurologic outcome
Serum glucose threshold of 150 mg/dl may not be the proper hyperglycemic threshold
Management of cardiopulmonary bypass during pediatric cardiac surgery has significantly changed since this study was performed
Observational design not originally intended to address glucose management
Weak correlation coefficients for EEG return
Uncertain relationship between return of EEG activity and neurologic outcome
Threshold of 150 mg/dl may not be the proper hyperglycemic threshold
Changes in pediatric cardiopulmonary bypass management since the study was performed

Discussion

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Implication

Unlike in adults, hyperglycemia does not appear to worsen neurologic outcomes after neonatal heart surgery, highlighting the importance of preventing hypoglycemia with dextrose-containing fluids.

Cite This Study

Loepke et al. (2004) conducted an editorial in Neonatal heart surgery (n=171). Hyperglycemia vs. Normal or low glucose levels was evaluated on Early or late neurologic or developmental outcome. High blood glucose levels during neonatal heart surgery were not associated with poor early or late neurologic or developmental outcomes.

synapsesocial.com/papers/6a9706ddc00de92d9bfbded9 https://doi.org/10.1097/00000542-200406000-00002

View Full Paper

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Implication

Unlike in adults, hyperglycemia does not appear to worsen neurologic outcomes after neonatal heart surgery, highlighting the importance of preventing hypoglycemia with dextrose-containing fluids.

Glucose and Heart Surgery: Neonates Are Not Just Small Adults

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Glucose and Heart Surgery: Neonates Are Not Just Small Adults

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider