1035 The Role of Hyperglycemia on Neurodevelopmental Outcome in Infants Operated for Congenital Heart Disease with Open-Heart Surgery

Abstract

Background: It is unclear whether hyperglycemia after infant cardiac surgery adversely affects neurodevelopmental outcome.Methods: Secondary analysis of a prospective cohort study on neurodevelopmental outcome after infant cardiac surgery. Exclusion criteria were: older than one year of age at first surgery, genetic disorders or dysmorphic syndromes and birth weight < 2000 grams and postoperative death. Of 368 children, 172 met inclusion criteria. Ten children did not yet return for the one year follow up examination and two were lost to follow-up. Follow-up examination at four years was available for 56 children, the remaining children were too young. Postoperative highest and lowest glucose levels within 24 hours after bypass surgery were prospectively collected. Neurodevelopmental outcome at one year of age was assessed with the Bayley Scales of Infant Development II (Mental Developmental Index-MDI, Psychomotor Developmental Index-PDI) in 160 children and at four years with the WPPSI.Results: Mean age at surgery was 2.9 months (0.1-10.7 months). Mean highest postoperative glucose values were 12.76 (SD 4.9), mean lowest were 6.82 (SD 1.9). Glucose values normalized in all children within 48 hours, seven children (4%) received insulin infusions. Postoperative highest and lowest glucose levels were not associated with neurodevelopmental outcome at one year or at four years, whereas more abnormal preoperative neurological findings were associated with poorer one-year outcome (MDI p< 0.001, PDI=0.03).Conclusion: In our population glucose values normalized within 48 hours and had no adverse effect on neurodevelopmental outcome.