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[Hyperglycemia and mortality in critically ill children]

Borbála Mikos1, László Barkai

  • 1Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház, Gyermekegészségügyi Továbbképzo Intézet, IV. Gyermekosztály, Gyermek-Aneszteziológiai és Intenzív Osztály, Miskolc. mikos.gyekint@bazmkorhaz.hu

Orvosi Hetilap
|April 10, 2007
PubMed

Insights

In critically ill children, sustained hyperglycemia and higher blood glucose levels correlate with increased mortality. Sepsis is a significant factor in these metabolic disturbances.

Area of Science:

  • Pediatric critical care medicine
  • Endocrinology
  • Metabolic disorders

Context:

  • Stress-induced hyperglycemia is common in non-diabetic individuals with critical illness.
  • While adult studies link glycemic control to survival, pediatric data is limited.
  • Previous pediatric studies suggest a correlation between hyperglycemia and mortality.

Purpose:

  • To retrospectively investigate the relationship between blood glucose levels and pathological processes in a pediatric intensive care unit.
  • To determine if hyperglycemia predicts mortality in critically ill children.
  • To identify factors contributing to hyperglycemia in this population.

Summary:

  • Highest blood glucose values were linked to fatal outcomes (mean 14.38 mmol/l) and sepsis (mean 13.97 mmol/l), irrespective of diagnosis or outcome.
  • Patients with fatal outcomes had sustained hyperglycemia (mean 7.59 mmol/l) throughout treatment and on the last day (mean 7.00 mmol/l).
  • Survivors had significantly lower blood glucose levels (mean 6.52 mmol/l) over the treatment duration and on the last day (mean 5.28 mmol/l) compared to non-survivors.

Impact:

  • Findings suggest that critical illness in children, like in adults, induces sustained hyperglycemia.
  • Higher peak values and longer durations of elevated blood glucose are associated with increased mortality rates.
  • Sepsis is identified as a potent inducer of carbohydrate metabolism abnormalities in critically ill children.
Abstract

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