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Glycemic level in mechanically ventilated children with bronchiolitis
Ricardo G Branco1, Robert C Tasker
1Department of Paediatrics, University of Cambridge School of Medicine, Addenbrookes Hospital, Cambridge, UK. brancori@terra.com.br
Summary
Hyperglycemia is common in infants with bronchiolitis needing mechanical ventilation, but it does not independently prolong their hospital stay. This suggests tight glucose control may not be necessary for these children.
Area of Science:
- Pediatric critical care medicine
- Neonatology
- Infectious diseases
Background:
- Bronchiolitis is a common respiratory infection in infants.
- Mechanical ventilation is sometimes required for severe cases.
- Hyperglycemia has been associated with adverse outcomes in critically ill patients.
Purpose of the Study:
- To investigate the relationship between blood glucose levels and the duration of mechanical ventilation and pediatric intensive care unit (PICU) stay in children with bronchiolitis.
Main Methods:
- Retrospective cohort study of 50 children admitted to a university hospital PICU.
- Data collected included glucose levels, C-reactive protein, alanine transaminase, and clinical factors.
- Statistical analysis, including multiple regression, was used to identify associations.
Main Results:
- Hyperglycemia was frequent in children with bronchiolitis requiring mechanical ventilation (98% had peak glucose >= 6.1 mmol/L).
- Children with sustained hyperglycemia had more severe illness markers and required higher ventilator support.
- However, peak glucose and sustained hyperglycemia were not independently associated with longer mechanical ventilation or PICU stay.
Conclusions:
- Hyperglycemia is prevalent in mechanically ventilated children with bronchiolitis.
- This study did not find an independent association between hyperglycemia and prolonged PICU or mechanical ventilation duration.
- The findings question the routine use of strict glycemic control in this patient population.
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