Abstract 4571: Blood Glucose Negatively Correlates with Systemic Hemodynamics and Oxygen Transport and Cerebral Oxygenation in Neonates after the Norwood Procedure
It remains a common practice to ‘tolerate’ hyperglycemia in neonates after cardiopulmonary bypass. We sought to determine the relation between blood glucose and systemic and cerebral oxygen transport in neonates after the Norwood procedure. Systemic oxygen consumption (VO2) was measured using respiratory mass spectrometry for 72 hours in 17 neonates after the Norwood procedure. Cardiac output (CO), systemic and pulmonary vascular resistances (SVR, tPVR including B-T shunt), rate pressure product (RPP), cardiac power output (CPO), systemic oxygen delivery (DO2) and oxygen extraction ratio (ERO2), as well as blood glucose, were measured at 2 to 4 hour intervals. Cerebral oxygen saturation (ScO2) was measured by near-infrared spectroscopy. Blood glucose ranged from 2.8 to 24.6 mmol/L. Glucose significantly negatively correlated with CO (p=0.02), RPP (p=0.03), CPO (p=0.01), and ScO2 (p=0.01), and positively correlated with ERO2 (p=0.0003). It trended to positively correlated with SVR (p=0.08), negatively with DO2 (p=0.08) and VO2 (p=0.14), and positively with lactate (p=0.10). Blood glucose level negatively correlates with systemic hemodynamics, oxygen transport and cerebral oxygenation status in neonates after the Norwood procedure. Moderate glucose control with insulin therapy may provide an important treatment strategy to improve postoperative systemic and cerebral oxygen transport, and thus outcomes in neonates after CPB.