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Persistent hyperglycemia in critically ill children.

Edward Vincent Faustino1, Michael Apkon

  • 1Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520, USA.

The Journal of Pediatrics
|January 13, 2005
PubMed
Summary
This summary is machine-generated.

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Hyperglycemia is common in critically ill children without diabetes, increasing their risk of death and longer hospital stays. Early glucose monitoring is crucial for predicting outcomes in pediatric intensive care.

Area of Science:

  • Pediatric Critical Care Medicine
  • Endocrinology
  • Clinical Research

Background:

  • Hyperglycemia is a common metabolic derangement in critically ill patients.
  • The prognostic significance of hyperglycemia in critically ill nondiabetic children is not well-established.

Purpose of the Study:

  • To determine the prevalence of hyperglycemia in critically ill nondiabetic children.
  • To investigate the prognostic significance of hyperglycemia on in-hospital mortality and length of stay (LOS) in this population.

Main Methods:

  • Retrospective cohort study of 942 nondiabetic children admitted to a Pediatric Intensive Care Unit (PICU).
  • Utilized point-of-care blood glucose measurements, hospital administrative data, and a computerized information system.
  • Hyperglycemia defined by initial, 24-hour maximum, and 10-day maximum glucose levels using cutoff values of 120, 150, and 200 mg/dL.

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Main Results:

  • Prevalence of hyperglycemia ranged from 16.7% to 75.0% depending on the definition used.
  • Increased risk of in-hospital death observed with maximum glucose >150 mg/dL within 24 hours (RR 2.50) and highest glucose >120 mg/dL within 10 days (RR 5.68).
  • Length of stay (LOS) showed varied associations: decreased for admission glucose >120 or 150 mg/dL, but increased for maximum glucose within 10 days across all thresholds.

Conclusions:

  • Hyperglycemia is frequent in critically ill nondiabetic children.
  • Elevated glucose levels are associated with increased in-hospital mortality.
  • Hyperglycemia correlates with both decreased and increased length of stay, depending on the time point of measurement.