Impact of Cardiopulmonary Bypass and Aorta Cross Clamp Time on the Length of Mechanical Ventilation after Cardiac Surgery among Children: A Saudi Arabian Experience.

Aim Several factors determine the perioperative outcome besides the nature of the congenital heart defect. Prolonged mechanical ventilation (PMV) is a major factor that determines mortality, length of stay (LOS), residual disability, and other functional outcomes. We aim to determine the clinical variables predicting PMV and LOS in hospital, and specifically the impact from the duration of cardiopulmonary bypass (CPB) and aortic cross-clamp (ACC). Method We conducted a retrospective review of the medical records of 413 children consecutively admitted to the Pediatric Cardiac Intensive Care Unit (PCICU) in one year at a single center. We collected demographic information (e.g., age, gender, and weight), perioperative variables, clinical outcomes, length of mechanical ventilation, high-frequency ventilator use, and mortality. We used logistic regression to analyze the data. PMV was defined as mechanical ventilation for longer than seven days. Results A total of 410 records were included in our study. We found no statistically significant association between CPB time and mechanical ventilation days. Forty-seven children had PMV, 362 did not have PMV. We found no statistically significant association between CPB time and mechanical ventilation days after adjusting for covariates. Reanalyzing the data with PMV defined as longer than four days produced the same results. Using a regression model to assess the variables via the least absolute shrinkage and selection operator for feature selection, we found no statistically significant association between ACC time and mechanical ventilation days after adjusting for covariates. Conclusion According to our results, CPB and ACC time are not associated with PMV or prolonged hospital LOS.

Discordant association of the CREBRF rs373863828 A allele with increased BMI and protection from type 2 diabetes in Maori and Pacific (Polynesian) people living in Aotearoa/New Zealand.

AIMS/HYPOTHESIS: The A (minor) allele of CREBRF rs373863828 has been associated with increased BMI and reduced risk of type 2 diabetes in the Samoan populations of Samoa and American Samoa. Our aim was to test rs373863828 for associations with BMI and the odds of type 2 diabetes, gout and chronic kidney disease (CKD) in Maori and Pacific (Polynesian) people living in Aotearoa/New Zealand. METHODS: Linear and logistic regression models were used to analyse the association of the A allele of CREBRF rs373863828 with BMI, log-transformed BMI, waist circumference, type 2 diabetes, gout and CKD in 2286 adults. The primary analyses were adjusted for age, sex, the first four genome-wide principal components and (where appropriate) BMI, waist circumference and type 2 diabetes. The primary analysis was conducted in ancestrally defined groups and association effects were combined using meta-analysis. RESULTS: For the A allele of rs373863828, the effect size was 0.038 (95% CI 0.022, 0.055, p = 4.8 × 10-6) for log-transformed BMI, with OR 0.59 (95% CI 0.47, 0.73, p = 1.9 × 10-6) for type 2 diabetes. There was no evidence for an association of genotype with variance in BMI (p = 0.13), and nor was there evidence for associations with serum urate (ß = 0.012 mmol/l, pcorrected = 0.10), gout (OR 1.00, p = 0.98) or CKD (OR 0.91, p = 0.59). CONCLUSIONS/INTERPRETATION: Our results in New Zealand Polynesian adults replicate, with very similar effect sizes, the association of the A allele of rs373863828 with higher BMI but lower odds of type 2 diabetes among Samoan adults living in Samoa and American Samoa.