The effect of different glucose control schemes on clinical outcomes of congenital heart disease in infants under age of 6 months  

作　　者：陈妙云 朱卫中 罗丹东 

机构地区：[1]Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences

出　　处：《South China Journal of Cardiology》2017年第4期249-254,326,共7页岭南心血管病杂志（英文版）

基　　金：supported by National Science&Technology Support Program during the Twelfth Five-year Plan Period(No.2011BAI11B22)

摘　　要：Background It remains controversial whether intensive control of glucose is required for pediatric hyperglycemia and no consensus has been reached on the threshold for blood glucose control for perioperative pediatric patients. Few studies have been available on the blood glucose control for the infants receiving congenital heart disease operation. So far, there are no uniform standards to control hyperglycemmia after congenital heart disease operation. In this paper, we determined the ranges and methods of postoperative blood glycemic control in infants with congenital heart disease. Methods Eighty-two infants under 6 months of age, who underwent correction of congenital heart disease in our hospital from 06/01/2014 to 06/01/2015, participated in this study. All patients were randomly divided into two groups according to random number table method： group A （insulin control group） and group B （non-insulin control group）. Each group was furhter divided into three subgroups （A1-A3, B1- B3）. Children in group A were treated using the glycemic control therapy with insulin. Children in group B received a glycemic control therapy without insulin. Femoral vein blood was drew in 72 hours after the operation to check WBC, CRP, lactate, ALT and Cr. The duration of ICU, incidence of lung infection, incidence of hypogly- cemia, and mortality were measured and computed. Results The differences of Cr, ALT, WBC and CRP index between A and B subgroups were statistically significant （P 〈 0.05）. There were no significant differences in ALT, Cr, WBC and CRP levels between the A and B groups （P 〉 0.05）. The stay time of ICU in group A2 was significantly less than that in A1 or A3 group. ICU stay time was significantly less in group B2 than in B1 or B3 group. The incidence of pulmonary infection and hypoglycemia in 2 groups were lower than those in A1 and A3 group. There was no significant difference （P 〉 0.05） in the incidence of complications in B subgroups and between the two groups. Conclusions HigBackground It remains controversial whether intensive control of glucose is required for pediatric hyperglycemia and no consensus has been reached on the threshold for blood glucose control for perioperative pediatric patients. Few studies have been available on the blood glucose control for the infants receiving congenital heart disease operation. So far, there are no uniform standards to control hyperglycemmia after congenital heart disease operation. In this paper, we determined the ranges and methods of postoperative blood glycemic control in infants with congenital heart disease. Methods Eighty-two infants under 6 months of age, who underwent correction of congenital heart disease in our hospital from 06/01/2014 to 06/01/2015, participated in this study. All patients were randomly divided into two groups according to random number table method： group A （insulin control group） and group B （non-insulin control group）. Each group was furhter divided into three subgroups （A1-A3, B1- B3）. Children in group A were treated using the glycemic control therapy with insulin. Children in group B received a glycemic control therapy without insulin. Femoral vein blood was drew in 72 hours after the operation to check WBC, CRP, lactate, ALT and Cr. The duration of ICU, incidence of lung infection, incidence of hypogly- cemia, and mortality were measured and computed. Results The differences of Cr, ALT, WBC and CRP index between A and B subgroups were statistically significant （P 〈 0.05）. There were no significant differences in ALT, Cr, WBC and CRP levels between the A and B groups （P 〉 0.05）. The stay time of ICU in group A2 was significantly less than that in A1 or A3 group. ICU stay time was significantly less in group B2 than in B1 or B3 group. The incidence of pulmonary infection and hypoglycemia in 2 groups were lower than those in A1 and A3 group. There was no significant difference （P 〉 0.05） in the incidence of complications in B subgroups and between the two groups. Conclusions Hig

关 键 词：congenital heart disease INFANTS blood sugar 

分 类 号：R726.5[医药卫生—儿科]