Indian J Crit Care Med. 2014 Jan;18(1):8-13. doi: 10.4103/0972-5229.125427.
Hyperglycemia in critically ill children.
Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
Vinayak Krishnarao Patki, Swati Balasaheb Chougule
Affiliations
Affiliations
- Department of Pediatrics, Wanless Hospital Miraj, India.
- Department of Pediatrics, Bharati Vidyapeeth University Medical College, Sangli, Maharashtra, India.
PMID: 24550607
PMCID: PMC3912677 DOI: 10.4103/0972-5229.125427
Abstract
OBJECTIVES: To determine the incidence and study association of hyperglycemia with outcome of critically ill children.
SETTING AND DESIGN: This was a prospective observational study conducted in eight bedded pediatric intensive care unit (PICU) of a tertiary care hospital.
MATERIALS AND METHODS: One hundred and one critically ill non-diabetic children between ages of 1 month to 16 years were studied from the day of admission till discharge or death. Serial blood sugars were determined first at admission, thereafter every 12 hourly in all children. Blood glucose level above 126 mg/dl (>7 mmol/dl) was considered as hyperglycemia. Children with hyperglycemia were followed 6 hourly till blood glucose fell below 126 mg/dl. Hyper and non-hyperglycemic children were compared with respect to length of stay, mechanical ventilation, use of inotrops and final outcome. Survivors and non-survivors were compared in relation to admission blood glucose, peak blood glucose level and duration of hyperglycemia.
RESULTS: Seventy (69.3%) children had hyperglycemia. Requirement of ventilation [(23) 32.9% vs.(3) 9.7%], requirement of inotropic support [(27) 38.6% vs.(5) 16.1%], Mean length of stay in PICU (7.91 ± 5.01 vs. 5.58 ± 1.95 days) and mortality (28.6% vs. 3.2%) among hyperglycemic children was significantly higher (P < 0.05) than that of non-hyperglycemic. Logistic regression analysis showed Peak blood glucose level and duration of hyperglycemia has independent association with increased risk of death.
CONCLUSION: Incidence of hyperglycemia is high in critically ill children and it is associated with high morbidity and mortality.
Keywords: Critically ill children; hyperglycemia; pediatric intensive care unit
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