To estimate the pooled prevalence of postoperative dysglycemia and describe associated postoperative outcomes in pediatric cardiac surgery.
Approach:
Systematic Review and Meta-Analysis: Conducted following PRISMA 2020 guidelines and JBI methodology, including studies on pediatric patients undergoing cardiac surgery reporting postoperative dysglycemia.
Key Findings:
Pooled prevalence of postoperative dysglycemia was 68.6% (95% CI 52.8 to 81.0).
Hyperglycemia accounted for 71.2% of cases, while hypoglycemia was observed in 8.1%.
Prevalence was higher in Asia and North America (~75%) compared to Europe (45.2%), though not statistically significant.
Studies using lower hyperglycemia thresholds (126–139 mg/dL) reported the highest prevalence (82.3%, p<0.032).
Mean ICU stay among dysglycemic patients was 180.3 hours (95% CI 82.3 to 279.3), and mean mechanical ventilation duration was 94.6 hours (95% CI 5.2 to 184.1).
Interpretation:
Dysglycemia is highly prevalent following pediatric cardiac surgery, particularly hyperglycemia, with prolonged ICU and mechanical ventilation times among affected patients.
Limitations:
Variability in definitions and measurement approaches across studies.
Moderate certainty of evidence assessed using the GRADE approach.
Conclusion:
Dysglycemia is prevalent in pediatric cardiac surgery, necessitating vigilant perioperative glucose monitoring and standardized management protocols.
