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Intraoperative Blood Glucose Levels and Postoperative Acute Kidney Injury in Pediatric Patients Having Congenital Heart Surgery under Cardiopulmonary Bypass

Dongyun Bie1,#, Hongbai Wang1,#, Chaobin Zhang2, Chunrong Wang3, Yuan Jia1, Su Yuan1, Sheng Shi1, Jiangshan Huang1, Jianhui Wang1,*, Fuxia Yan1,*

1 Department of Anesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
2 Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China
3 Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China

* Corresponding Authors: Jianhui Wang. Email: email; Fuxia Yan. Email: email
# Contributed equally as co-first authors

Congenital Heart Disease 2023, 18(4), 475-488. https://doi.org/10.32604/chd.2023.028017

Abstract

Purpose: This study sought to explore the effect of intraoperative mean blood glucose levels and variability on postoperative acute kidney injury (AKI) in children undergoing congenital cardiac surgery. Methods: We conducted a prospective nested case-control study in children (age < 18 years) undergoing congenital heart surgery with cardiopulmonary bypass (CPB) at the Fuwai Hospital between April 01, 2022 and July 30, 2022. Cases were individuals who developed AKI within the first postoperative 7 days (AKI group) and controls were those without AKI (Non-AKI group) according to KDIGO criteria. AKI and Non-AKI groups unmatched and 1:1 matched by age, sex, and baseline serum creatinine were separately analyzed. Multivariate logistic and conditional logistic regressions were used to assess the associations between blood glucose variables and AKI. Results: 688 consecutively approached patients were included in the final analysis. On multivariate analysis, intra-CPB (adjusted odds ratio [OR] 0.802; 95% confidence interval [CI], 0.706 to 0.912; p = 0.001) and post-CPB (adjusted OR 0.830; 95% CI, 0.744 to 0.925; p = 0.001) blood glucose levels were associated with postoperative AKI. There were no significant differences in pre-CPB blood glucose (adjusted OR 0.926; 95% CI, 0.759 to 1.129; p = 0.446) or intraoperative glycemic fluctuations (adjusted OR 0.905; 95% CI, 0.723 to 1.132; p = 0.382) between AKI and Non-AKI groups. Results based on matched cases and controls were consistent with those from the unmatched analyses. Conclusion: Higher intraoperative blood glucose levels during and after CPB were protective factors against postoperative AKI in pediatric patients after congenital heart surgery.

Graphic Abstract

Intraoperative Blood Glucose Levels and Postoperative Acute Kidney Injury in Pediatric Patients Having Congenital Heart Surgery under Cardiopulmonary Bypass

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Cite This Article

APA Style
Bie, D., Wang, H., Zhang, C., Wang, C., Jia, Y. et al. (2023). Intraoperative blood glucose levels and postoperative acute kidney injury in pediatric patients having congenital heart surgery under cardiopulmonary bypass. Congenital Heart Disease, 18(4), 475-488. https://doi.org/10.32604/chd.2023.028017
Vancouver Style
Bie D, Wang H, Zhang C, Wang C, Jia Y, Yuan S, et al. Intraoperative blood glucose levels and postoperative acute kidney injury in pediatric patients having congenital heart surgery under cardiopulmonary bypass. Congeni Heart Dis. 2023;18(4):475-488 https://doi.org/10.32604/chd.2023.028017
IEEE Style
D. Bie et al., "Intraoperative Blood Glucose Levels and Postoperative Acute Kidney Injury in Pediatric Patients Having Congenital Heart Surgery under Cardiopulmonary Bypass," Congeni. Heart Dis., vol. 18, no. 4, pp. 475-488. 2023. https://doi.org/10.32604/chd.2023.028017



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This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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