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Published on: June 11, 2012

Glucose control, organ failure, and mortality in pediatric intensive care

Michael Yung1, Barry Wilkins, Lynda Norton

  • 1The Women's and Children's Hospital, Adelaide, South Australia.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|May 15, 2008
PubMed

Insights

Hyperglycemia is common in pediatric intensive care units (PICUs), affecting 89% of ventilated children and increasing the risk of organ failure and death. However, early hyperglycemia does not predict later organ dysfunction, and insulin use is rare.

Area of Science:

  • Pediatric Critical Care Medicine
  • Endocrinology
  • Clinical Research

Background:

  • Hyperglycemia is a frequent complication in critically ill children.
  • Understanding its prevalence and impact in pediatric intensive care units (PICUs) is crucial for patient outcomes.

Purpose of the Study:

  • To determine the prevalence of hyperglycemia in ventilated children.
  • To assess the association between hyperglycemia and organ failure.
  • To document glycemic control practices in Australasian PICUs.

Main Methods:

  • Prospective inception cohort study conducted in nine specialist PICUs across Australia and New Zealand.
  • Included 409 children ventilated for over 12 hours, excluding specific conditions.
  • Collected blood glucose measurements, clinical data for PELOD scores, and insulin use for up to 14 days.

Main Results:

  • 89% of patients experienced peak blood glucose levels > 6.1 mmol/L, with hyperglycemia identified in 13% of subjects.
  • Hyperglycemia was independently associated with a higher Paediatric Logistic Organ Dysfunction (PELOD) score (≥10) and increased mortality.
  • Early hyperglycemia (first 48 hours) showed associations with outcomes but not with later or worsening organ failure.

Conclusions:

  • Hyperglycemia is prevalent, occurs early, and is linked to organ failure and death in PICU patients.
  • Early hyperglycemia is not predictive of subsequent or escalating organ dysfunction.
  • Insulin therapy is infrequently utilized in Australasian PICUs.
Abstract

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