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Control of hyperglycaemia in paediatric intensive care (CHiP): study protocol
Duncan Macrae1, John Pappachan, Richard Grieve
1Paediatric Intensive Care Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. D.macrae@rbht.nhs.uk
BMC Pediatrics
|February 9, 2010
Summary
This study investigates if tight blood glucose (BG) control benefits critically ill children. Further assessment is needed before implementing tight BG management in pediatric intensive care units.
Area of Science:
- Pediatric Critical Care Medicine
- Metabolic Regulation in Children
- Intensive Care Unit (ICU) Management
Background:
- Adult studies suggest tight blood glucose (BG) control improves outcomes in critical illness.
- Children exhibit similar hyperglycemic responses to critical illness and surgery.
- The benefit of tight BG control in pediatric populations remains unestablished due to developmental differences and varied disease spectrums.
Purpose of the Study:
- To determine if tight BG control increases ventilator-free days in critically ill children (<16 years).
- To evaluate the impact of tight BG control on ICU-related complications and cost-effectiveness.
- To assess long-term outcomes, including vital status and healthcare resource utilization.
Main Methods:
- Randomized open trial comparing tight BG control (4-7.0 mmol/l) with standard care in ventilated pediatric ICU patients.
- Enrolled children aged ≤16 years requiring vasoactive support for ≥12 hours.
- Follow-up included vital status, healthcare usage, and neurobehavioral assessment in a traumatic brain injury subgroup.
Main Results:
- The study is designed to detect a 2-day difference in 30-day ventilator-free days with 90% power.
- A sample size of 1000-1500 patients is required for adequate statistical power.
- Economic evaluation will assess the cost-effectiveness of tight BG control.
Conclusions:
- Formal assessment of tight glycemic control in critically ill children is necessary.
- Evidence is required before widespread adoption into standard pediatric intensive care practice.
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