Related Experiment Video

Updated: Aug 13, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Impact of tight glycemic control in severely burned children

Tam N Pham1, Aimee J Warren, Ho H Phan

  • 1University of California Davis, Shriners Hospitals for Children Northern California, Sacramento, California 95817, USA.

The Journal of Trauma
|December 31, 2005
PubMed

Insights

Strict glucose control using intensive insulin therapy in pediatric burn patients significantly reduced infections and improved survival. This approach is safe and effective for managing hyperglycemia in severely burned children.

Area of Science:

  • Pediatric critical care medicine
  • Burn injury management
  • Endocrinology

Background:

  • Hyperglycemia control reduces mortality in critically ill adults, but its pediatric benefits are unclear.
  • A pediatric burn center implemented intensive insulin therapy (IIT) targeting 90-120 mg/dL glucose levels.
  • This study evaluated the impact of IIT on pediatric burn patient outcomes.

Purpose of the Study:

  • To assess the efficacy of intensive insulin therapy in pediatric burn patients.
  • To compare patient outcomes between conventional and intensive insulin therapy.
  • To determine the effect of IIT on infection rates and survival.

Main Methods:

  • Retrospective review of pediatric patients with >=30% total body surface area (TBSA) burn.
  • Comparison of patients receiving conventional insulin therapy (2000-2001) versus intensive insulin therapy (2002-2003).
  • Analysis of glucose control, infection rates, and survival between the two groups.

Main Results:

  • Intensive insulin therapy group achieved target glucose levels (90-120 mg/dL) more consistently.
  • A significant reduction in urinary tract infections was observed in the IIT group.
  • IIT was positively associated with improved patient survival, despite similar injury severity.

Conclusions:

  • Intensive insulin therapy for maintaining normoglycemia in severely burned children is safe and effective.
  • IIT demonstrated a potential to lower infection rates and enhance survival.
  • Consideration of IIT is recommended for pediatric patients with severe burn injuries.
Abstract

Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Burn Injuries01:22

Burn Injuries

Burn injuries occur when the skin and underlying tissues are damaged due to exposure to heat, electricity, chemicals, radiation, or friction. They can vary in severity, from minor superficial burns to severe deep burns that can be life-threatening.
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
Diabetic Ketoacidosis ll: Pathophysiology01:22

Diabetic Ketoacidosis ll: Pathophysiology

Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...
Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Complications of Diabetes Mellitus01:22

Complications of Diabetes Mellitus

Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency, resistance, or both. Prolonged hyperglycemia disrupts metabolic homeostasis and leads to acute and chronic complications.Acute ComplicationsAcute complications result from sudden metabolic imbalance.Diabetic ketoacidosis (DKA) mainly appears in type 1 diabetes but may also develop in type 2 diabetes, particularly under extreme stress. It arises from severe insulin deficiency,...