TY  - EJOU
AU  - Bie, Dongyun 
AU  - Wang, Hongbai 
AU  - Zhang, Chaobin 
AU  - Wang, Chunrong 
AU  - Jia, Yuan 
AU  - Yuan, Su 
AU  - Shi, Sheng 
AU  - Huang, Jiangshan 
AU  - Wang, Jianhui 
AU  - Yan, Fuxia 

TI  - Intraoperative Blood Glucose Levels and Postoperative Acute Kidney Injury in Pediatric Patients Having Congenital Heart Surgery under Cardiopulmonary Bypass
T2  - Structural and Congenital Heart Disease

PY  - 2023
VL  - 18
IS  - 4
SN  - 3071-1738

AB  -  <b>Purpose:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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; <i>p </i>= 0.001) and post-CPB (adjusted OR 0.830; 95% CI, 0.744 to 0.925; <i>p </i>= 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; <i>p </i>= 0.446) or intraoperative glycemic fluctuations (adjusted OR 0.905; 95% CI, 0.723 to 1.132; <i>p </i>= 0.382) between AKI and Non-AKI groups. Results based on matched cases and controls were consistent with those from the unmatched analyses. <b>Conclusion:</b> Higher intraoperative blood glucose levels during and after CPB were protective factors against postoperative AKI in pediatric patients after congenital heart surgery.
KW  - Blood glucose; children; congenital heart surgery; cardiopulmonary bypass; acute kidney injury

DO  - 10.32604/chd.2023.028017