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Glycemic Stress Index: Does It Correlate with the Intensive Care Length of Stay?
Postoperative hyperglycemia is an independent risk factor for postoperative complications. In adults, perioperative hyperglycemia is influenced by prolonged fasting, but data in children are lacking. The Glycemic Stress Index (GSI) has been shown to predict prolonged Pediatric Intensive Care Unit (P...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954865/ https://www.ncbi.nlm.nih.gov/pubmed/36832457 http://dx.doi.org/10.3390/children10020328 |
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author | Georges, Mathieu Engelhardt, Thomas Ingelmo, Pablo Mentegazzi, Federico Bertolizio, Gianluca |
author_facet | Georges, Mathieu Engelhardt, Thomas Ingelmo, Pablo Mentegazzi, Federico Bertolizio, Gianluca |
author_sort | Georges, Mathieu |
collection | PubMed |
description | Postoperative hyperglycemia is an independent risk factor for postoperative complications. In adults, perioperative hyperglycemia is influenced by prolonged fasting, but data in children are lacking. The Glycemic Stress Index (GSI) has been shown to predict prolonged Pediatric Intensive Care Unit (PICU) stays in neurosurgical patients. This study aimed to confirm the correlation between GSI and duration of intubation, PICU stay, and postoperative complications in infants undergoing elective open heart surgery. The correlation between preoperative fasting and GSI was also investigated. Methods: A retrospective chart review of 85 infants ≤ 6 months undergoing elective open heart surgery was performed. GSI values ≥ 3.9 and 4.5 were tested to determine whether they carried a higher incidence of postoperative complications (metabolic uncoupling, kidney injury, ECMO, and death). The correlation between GSI and the length of intubation, PICU stay, and duration of fasting were also investigated. Perioperative factors such as age, weight, blood gas analysis, use of inotropes, and risk adjustment for congenital heart surgery were also analyzed as possible predictors. Results: GSI correlated with the duration of intubation and PICU stay. A GSI ≥ 4.5, but not 3.9, was associated with a higher incidence of metabolic uncoupling. GSI was not influenced by preoperative fasting. None of the preoperative patient factors analyzed was associated with prolonged intubation, PICU stay, or PICU complications. An abnormal creatinine before surgery increased the risk of developing acute kidney injury postoperatively. Conclusions: GSI may be valuable to predict prolonged intubation, PICU stay, and metabolic derangement in infants undergoing cardiac surgery. Fasting does not appear to affect GSI. |
format | Online Article Text |
id | pubmed-9954865 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-99548652023-02-25 Glycemic Stress Index: Does It Correlate with the Intensive Care Length of Stay? Georges, Mathieu Engelhardt, Thomas Ingelmo, Pablo Mentegazzi, Federico Bertolizio, Gianluca Children (Basel) Brief Report Postoperative hyperglycemia is an independent risk factor for postoperative complications. In adults, perioperative hyperglycemia is influenced by prolonged fasting, but data in children are lacking. The Glycemic Stress Index (GSI) has been shown to predict prolonged Pediatric Intensive Care Unit (PICU) stays in neurosurgical patients. This study aimed to confirm the correlation between GSI and duration of intubation, PICU stay, and postoperative complications in infants undergoing elective open heart surgery. The correlation between preoperative fasting and GSI was also investigated. Methods: A retrospective chart review of 85 infants ≤ 6 months undergoing elective open heart surgery was performed. GSI values ≥ 3.9 and 4.5 were tested to determine whether they carried a higher incidence of postoperative complications (metabolic uncoupling, kidney injury, ECMO, and death). The correlation between GSI and the length of intubation, PICU stay, and duration of fasting were also investigated. Perioperative factors such as age, weight, blood gas analysis, use of inotropes, and risk adjustment for congenital heart surgery were also analyzed as possible predictors. Results: GSI correlated with the duration of intubation and PICU stay. A GSI ≥ 4.5, but not 3.9, was associated with a higher incidence of metabolic uncoupling. GSI was not influenced by preoperative fasting. None of the preoperative patient factors analyzed was associated with prolonged intubation, PICU stay, or PICU complications. An abnormal creatinine before surgery increased the risk of developing acute kidney injury postoperatively. Conclusions: GSI may be valuable to predict prolonged intubation, PICU stay, and metabolic derangement in infants undergoing cardiac surgery. Fasting does not appear to affect GSI. MDPI 2023-02-09 /pmc/articles/PMC9954865/ /pubmed/36832457 http://dx.doi.org/10.3390/children10020328 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Brief Report Georges, Mathieu Engelhardt, Thomas Ingelmo, Pablo Mentegazzi, Federico Bertolizio, Gianluca Glycemic Stress Index: Does It Correlate with the Intensive Care Length of Stay? |
title | Glycemic Stress Index: Does It Correlate with the Intensive Care Length of Stay? |
title_full | Glycemic Stress Index: Does It Correlate with the Intensive Care Length of Stay? |
title_fullStr | Glycemic Stress Index: Does It Correlate with the Intensive Care Length of Stay? |
title_full_unstemmed | Glycemic Stress Index: Does It Correlate with the Intensive Care Length of Stay? |
title_short | Glycemic Stress Index: Does It Correlate with the Intensive Care Length of Stay? |
title_sort | glycemic stress index: does it correlate with the intensive care length of stay? |
topic | Brief Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954865/ https://www.ncbi.nlm.nih.gov/pubmed/36832457 http://dx.doi.org/10.3390/children10020328 |
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