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Incidence and risk factors for perioperative hyperglycemia in children with traumatic brain injury

Deepak Sharma1, Jill Jelacic, Rohini Chennuri

  • 1Department of Anesthesiology, Harborview Medical Center, University of Washington, Seattle, Washington 98104, USA.

Anesthesia and Analgesia
|December 20, 2008
PubMed

Insights

Perioperative hyperglycemia is common in children with traumatic brain injury (TBI) and is linked to younger age, severe injury, and multiple lesions. More frequent glucose monitoring may be needed to manage blood sugar levels effectively.

Area of Science:

  • Pediatric critical care
  • Neurotrauma
  • Endocrinology

Background:

  • Hyperglycemia following traumatic brain injury (TBI) is linked to poorer patient outcomes.
  • Understanding the incidence and risk factors of perioperative hyperglycemia in pediatric TBI is crucial for improving patient care.

Purpose of the Study:

  • To determine the incidence of perioperative hyperglycemia and hypoglycemia in children with TBI.
  • To identify independent predictors of perioperative hyperglycemia in this patient population.

Main Methods:

  • A retrospective cohort study of children (<=13 years) undergoing craniotomy for TBI.
  • Collected preoperative, intraoperative, and postoperative glucose values.
  • Used multivariate logistic regression to identify risk factors for hyperglycemia.

Main Results:

  • 45% of children experienced hyperglycemia during the perioperative period.
  • Independent predictors included younger age (<4 years), severe TBI (Glasgow Coma Scale <=8), and multiple lesions (e.g., subdural hematoma).
  • Hypoglycemia occurred in 2 children, unrelated to insulin treatment.

Conclusions:

  • Perioperative hyperglycemia is prevalent in pediatric TBI patients.
  • Younger age, severe TBI, and multiple lesions are significant risk factors.
  • Increased intraoperative glucose monitoring may be warranted to accurately assess glycemic control.
Abstract

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