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Hyperglycemia in the pediatric intensive care unit
Genna W Klein1, Joanne M Hojsak, Robert Rapaport
1Division of Pediatric Endocrinology and Diabetes, Kravis Children's Hospital at Mount Sinai, New York 10029, USA.
Current Opinion in Clinical Nutrition and Metabolic Care
|February 8, 2007
Summary
Hyperglycemia (high blood sugar) is linked to worse outcomes in critically ill children. Further research is needed to establish optimal glucose control strategies in pediatric intensive care units.
Area of Science:
- Pediatric Critical Care Medicine
- Endocrinology
- Metabolic Disorders
Background:
- Glycemic control benefits critically ill adults.
- Limited data exists for pediatric intensive care settings.
- Hyperglycemia mechanisms in critically ill children are under investigation.
Purpose of the Study:
- Review adult literature on glycemic control benefits.
- Outline hyperglycemia's effects in critically ill patients, especially children.
- Discuss studies linking hyperglycemia to poor outcomes in pediatric ICUs.
Main Methods:
- Literature review of sentinel adult papers.
- Analysis of studies on pediatric intensive care populations.
- Examination of retrospective and prospective cohort studies.
Main Results:
- Hyperglycemia associated with worse outcomes in critically ill children.
- Specific patient groups (trauma, sepsis, burns, neonates) show negative associations.
- Glucose variability (peak, duration, excursion) may be more critical than absolute levels.
Conclusions:
- Glucose control in pediatric ICUs is gaining attention.
- Large prospective studies are required for pediatric-specific guidelines.
- Further research needed on pediatric disease variations, target values, and hypoglycemia risks.
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