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Hyperglycemia is associated with increased morbidity and mortality rates in neonates with necrotizing enterocolitis

N J Hall1, M Peters, S Eaton

  • 1Department of Surgery, Institute of Child Health and Great Ormond Street Hospital, London, England, UK.

Journal of Pediatric Surgery
|June 9, 2004
PubMed

Insights

Hyperglycemia is common in infants with necrotizing enterocolitis (NEC) and is linked to increased late mortality and longer intensive care unit stays. Aggressive glucose control may improve outcomes for these critically ill infants.

Area of Science:

  • Neonatal intensive care
  • Pediatric critical care medicine
  • Endocrinology

Background:

  • Hyperglycemia is associated with poor outcomes in critically ill adults and children.
  • Necrotizing enterocolitis (NEC) is a serious gastrointestinal condition in neonates.

Purpose of the Study:

  • To determine the incidence of hyperglycemia in infants with NEC.
  • To investigate the relationship between glucose levels and outcomes in infants with NEC.

Main Methods:

  • Retrospective review of 6508 glucose measurements in 95 neonates with confirmed NEC.
  • Determined maximum glucose concentration (Gmax) during admission for each infant.
  • Excluded 11 infants with treatment withdrawal within 24 hours.

Main Results:

  • 69% of infants experienced hyperglycemia (>8 mmol/L).
  • Mortality was higher in infants with Gmax > 11.9 mmol/L, particularly late mortality (29% vs 2%, P=.0009).
  • Gmax significantly correlated with longer intensive care unit (ICU) length of stay (P <.0001).

Conclusions:

  • Hyperglycemia is prevalent in infants with NEC admitted to the ICU.
  • Hyperglycemia is associated with increased late mortality and prolonged ICU stays.
  • Aggressive glycemic control may be beneficial for improving outcomes in this patient population.
Abstract

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