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[Hyperglycemia, morbidity and mortality in critically ill children: critical analysis based on a systematic review]

Eduardo Mekitarian Filho1, Werther Brunow de Carvalho, Eduardo Juan Troster

  • 1Instituto da Criança Professor Pedro de Alcântara da Universidade de São Paulo, S. Paulo, Brazil. emf2002@uol.com.br

Revista Da Associacao Medica Brasileira (1992)
|September 15, 2009
PubMed

Insights

Hyperglycemia in critically ill children admitted to the pediatric intensive care unit (PICU) is linked to increased morbidity and mortality. Further prospective studies are needed to confirm these findings and address methodological limitations.

Area of Science:

  • Pediatric Critical Care Medicine
  • Endocrinology
  • Clinical Research Methodology

Background:

  • Hyperglycemia is a common metabolic derangement in critically ill pediatric patients.
  • The impact of hyperglycemia on morbidity and mortality in this population requires thorough investigation.

Purpose of the Study:

  • To determine if hyperglycemia is a risk factor for increased morbidity and mortality in critically ill pediatric patients.
  • To critically analyze existing pediatric and neonatology literature on this topic.

Main Methods:

  • Systematic literature review of Medline, Cochrane, Lilacs, and Embase databases.
  • Inclusion of cohort studies (retrospective and prospective) in Portuguese, English, and Spanish.
  • Evaluation of outcomes including PICU and hospital mortality, length of stay, infection risk, and mechanical ventilation time.

Main Results:

  • 79 articles were initially selected, with 15 cohort studies (2 prospective, 13 retrospective) analyzed.
  • Analysis of cohort studies indicated that hyperglycemia increases morbidity, mortality, and length of stay in the PICU for critically ill children.

Conclusions:

  • Hyperglycemia, whether isolated or persistent, is associated with worse outcomes in critically ill children.
  • Methodological limitations in existing studies, including glucose measurement protocols and study design, necessitate further prospective research.
  • Hyperglycemia's role as a singular predictor of morbidity and mortality in pediatrics requires additional investigation.
Abstract

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