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Hypoglycemia in critically ill children

E Vincent S Faustino1, Eliotte L Hirshberg, Clifford W Bogue

  • 1Yale University School of Medicine, New Haven, Connecticut 06520, USA. vince.faustino@yale.edu

Journal of Diabetes Science and Technology
|March 10, 2012
PubMed

Insights

Hypoglycemia in critically ill children is a concern. Defining it as <40-45 mg/dl in neonates and <60-65 mg/dl in children is suggested, as lower levels correlate with worse outcomes.

Area of Science:

  • Pediatric Critical Care Medicine
  • Neonatal Intensive Care
  • Pediatric Endocrinology

Background:

  • Glycemic control in critically ill patients often involves intravenous insulin, raising concerns about hypoglycemia, particularly in children.
  • Limited research exists on the specific impact of hypoglycemia in pediatric and neonatal populations.
  • This review addresses the existing literature on hypoglycemia in critically ill neonates and children.

Purpose of the Study:

  • To systematically review the literature on hypoglycemia in critically ill neonates and children.
  • To propose evidence-based definitions for hypoglycemia in these vulnerable patient groups.
  • To identify risk factors and suggest preventive strategies for hypoglycemia.

Main Methods:

  • A systematic literature review was conducted up to August 2011.
  • Databases searched included PubMed, Ovid MEDLINE, and ISI Web of Science.
  • Search terms focused on "hypoglycemia" and "critical illness" in pediatric populations (0-18 years).

Main Results:

  • 132 articles were included from an initial 513, highlighting hypoglycemia as a significant concern for pediatric intensivists.
  • Suggested hypoglycemia definitions: <40-45 mg/dl in neonates and <60-65 mg/dl in children.
  • Lower glucose levels are associated with adverse neurological outcomes, prolonged intensive care unit stays, and increased mortality.

Conclusions:

  • Current research often focuses on spontaneous hypoglycemia, neglecting insulin-induced hypoglycemia.
  • Further investigation into risk factors and outcomes of insulin-induced hypoglycemia is crucial.
  • Implementing precise monitoring and computerized protocols can help prevent hypoglycemia and improve outcomes.
Abstract

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