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Glucose level and risk of mortality in pediatric septic shock

Ricardo G Branco1, Pedro Celiny R Garcia, Jefferson P Piva

  • 1Paediatric Intensive Care Unit, Addenbrooke's Hospital, Cambridge, UK.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|June 29, 2005
PubMed

Insights

In children with septic shock, high serum glucose levels are linked to increased mortality. A peak glucose level over 178 mg/dL significantly raises the risk of death in pediatric patients.

Area of Science:

  • Pediatric critical care medicine
  • Endocrinology
  • Infectious diseases

Background:

  • Septic shock is a life-threatening condition in children.
  • Hyperglycemia is frequently observed in critically ill patients.
  • The prognostic value of glucose levels in pediatric septic shock requires further investigation.

Purpose of the Study:

  • To investigate the association between serum glucose levels and mortality in children experiencing septic shock.
  • To determine a specific glucose threshold predictive of mortality in this population.

Main Methods:

  • A prospective cohort study was conducted in a pediatric intensive care unit.
  • Fifty-seven children with fluid-refractory septic shock were enrolled over 32 months.
  • Peak serum glucose levels were measured and correlated with patient outcomes.

Main Results:

  • The overall mortality rate was 49.1%.
  • Nonsurvivors exhibited significantly higher peak glucose levels (262 +/- 110 mg/dL) compared to survivors (167.8 +/- 55 mg/dL).
  • A peak glucose level of >178 mg/dL was associated with a 2.59-fold increased risk of death (sensitivity 0.714, specificity 0.724).

Conclusions:

  • Elevated peak serum glucose levels are a significant predictor of mortality in pediatric septic shock.
  • A threshold of 178 mg/dL for peak glucose effectively identifies children at higher risk of death.
  • Monitoring glucose levels is crucial for risk stratification and management of pediatric septic shock.
Abstract

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