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Published on: June 11, 2012
Abnormalities in glucose homeostasis in critically ill children
Tsultem D Bhutia1, Rakesh Lodha, Sushil K Kabra
1Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Summary
Hyperglycemia is common in critically ill children. Blood glucose levels over 180 mg/dL are linked to increased mortality, while high glucose, low glucose, and glucose variability are associated with multiple organ dysfunction.
Area of Science:
- Pediatric critical care medicine
- Endocrinology
- Metabolic disorders
Background:
- Hyperglycemia is frequently observed in critically ill children.
- The impact of hyperglycemia, hypoglycemia, and glucose variability on outcomes in this population requires further investigation.
Purpose of the Study:
- To determine the prevalence of hyperglycemia in critically ill children.
- To assess the effects of hyperglycemia, glucose variability, and hypoglycemia on mortality, organ dysfunction, and length of pediatric intensive care unit (PICU) stay.
Main Methods:
- Prospective, observational cohort study.
- Data collected included blood glucose levels, clinical and laboratory parameters for scoring mortality and organ dysfunction, and medication use.
- Study conducted in the PICU of a tertiary care hospital from January 2009 to June 2010.
Main Results:
- Hyperglycemia (blood glucose >126 mg/dL) was observed in 78.24% of critically ill children.
- Blood glucose levels >180 mg/dL were associated with increased mortality.
- Hyperglycemia (>126 mg/dL), hypoglycemia (<40 mg/dL), and glucose variability were associated with multiple organ dysfunction.
Conclusions:
- Hyperglycemia is highly prevalent in critically ill children.
- Elevated blood glucose levels (>180 mg/dL) are linked to increased mortality.
- Hyperglycemia, hypoglycemia, and glucose variability are associated with multiple organ dysfunction in critically ill children.
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