Pediatric critical illness hyperglycemia: risk factors associated with development and severity of hyperglycemia in

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Catherine M Preissig1, Mark R Rigby

  • 1Department of Pediatrics, Division of Pediatric Critical Care Medicine, Emory University School of Medicine, Atlanta, GA, USA. Catherine.preissig@choa.org

The Journal of Pediatrics
|July 25, 2009
PubMed

Insights

Critical illness hyperglycemia (CIH) in children is more severe and lasts longer in critically ill patients with specific diagnoses and conditions. Identifying risk factors can predict which children develop CIH.

Area of Science:

  • Pediatric critical care medicine
  • Endocrinology
  • Metabolic disorders

Background:

  • Hyperglycemia is common in critically ill children.
  • Critical illness hyperglycemia (CIH) management is crucial for patient outcomes.
  • Understanding susceptibility and severity factors is essential for targeted treatment.

Purpose of the Study:

  • To identify children susceptible to CIH.
  • To determine if CIH severity and duration correlate with specific diagnoses or overall illness severity.
  • To establish predictive risk factors for CIH development.

Main Methods:

  • Developed a standardized approach for CIH identification and treatment in a pediatric intensive care unit.
  • Defined CIH as persistent blood glucose (BG) >140 mg/dL.
  • Retrospectively analyzed patient data from June 2006 to May 2007, focusing on hyperglycemia cases.

Main Results:

  • Average peak BG was 199 mg/dL, with an average CIH duration of 6.3 days.
  • Highest CIH severity and duration were observed in neurosurgical patients, those with sepsis, and patients requiring mechanical ventilation, vasopressors, or extracorporeal support.
  • Higher illness severity scores correlated with increased CIH severity and duration.

Conclusions:

  • CIH severity and duration are linked to specific diagnoses and the overall severity of illness in pediatric patients.
  • Certain identified risk factors may help predict which children are likely to develop CIH.
  • This study highlights the importance of monitoring and managing hyperglycemia in critically ill children.
Abstract

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