INS and infection: Inotrope score lower at 4 and 8 h postop in MP group p = 0.03  Lower highest inotrope-score first 36 h postoperatively  Insulin treatment ns  Infection ns  Poor wound healing ns No difference in primary endpoint in children <7 days vs. children > 7 days.  Interaction of center in which surgery takes place and treatment effect of MP; OR for primary endpoint overall center 1 0.35 (CI 0.15–0.84, p 0.02), center 2 OR 5.13 (0.85–30.9) though a protective effect in palliative surgery. In center 1 also reduced incidence of LCOS and inotrope score.