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We describe a case of a two\u2010year\u2010old girl with ornithine transcarbamylase deficiency who underwent cardiac surgery requiring cardiopulmonary bypass. A high\u2010dose dextrose infusion to prevent protein catabolism was given throughout surgery, which caused uncontrollable hyperglycaemia unresponsive to high\u2010dose insulin administration. Factors contributing to the hyperglycaemia may have included surgical stress, steroid administration and hypothermia. During invasive surgery, anaesthetists should carefully adjust the rates of dextrose and insulin infusions, guided by close monitoring of blood ammonia, glucose and lactate.<\/jats:p>","DOI":"10.1002\/anr3.12179","type":"journal-article","created":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T17:39:30Z","timestamp":1658338770000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Glycaemic management in a child with ornithine transcarbamylase deficiency undergoing cardiac surgery with hypothermic cardiopulmonary bypass"],"prefix":"10.1002","volume":"10","author":[{"given":"Y.","family":"Yamauchi","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Aichi Children's Health and Medical Center  Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Aichi Children's Health and Medical Center  Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7136-9815","authenticated-orcid":false,"given":"T.","family":"Kojima","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Aichi Children's Health and Medical Center  Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,7,20]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2005.01695.x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2017.10.005"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03322.x"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jimd.12100"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2007.tb00976.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13052-020-00939-9"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181aa5241"},{"key":"e_1_2_5_9_1","first-page":"CD013101","article-title":"Prophylactic corticosteroids for paediatric heart surgery with cardiopulmonary bypass","volume":"10","author":"Gibbison B","year":"2020","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/453752"}],"container-title":["Anaesthesia Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12179","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/anr3.12179","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12179","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T12:08:41Z","timestamp":1759925321000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1002\/anr3.12179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1002\/anr3.12179"],"URL":"https:\/\/doi.org\/10.1002\/anr3.12179","archive":["Portico"],"relation":{},"ISSN":["2637-3726","2637-3726"],"issn-type":[{"type":"print","value":"2637-3726"},{"type":"electronic","value":"2637-3726"}],"subject":[],"published":{"date-parts":[[2022,7]]},"assertion":[{"value":"2022-06-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12179"}}