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The Effect of Various, Everyday Practices on Glucose Levels in Critically Ill Children

Eleni Tsotridou1, Eirini Kotzapanagiotou2, Asimina Violaki2

  • 11st Department of Pediatrics, Aristotle University, Ippokratio General Hospital, Thessaloniki, Greece.

Journal of Diabetes Science and Technology
|October 7, 2020
PubMed

Insights

Intensive care unit (ICU) procedures, particularly in awake pediatric patients, significantly increase glucose levels. Continuous glucose monitoring reveals that even routine interventions can impact blood sugar in critically ill children.

Area of Science:

  • Pediatric Critical Care Medicine
  • Endocrinology
  • Medical Technology

Background:

  • Critically ill pediatric patients often experience glycemic variability.
  • Understanding the impact of routine intensive care unit (ICU) interventions on glucose levels is crucial.
  • Continuous glucose monitoring (CGM) systems offer a novel approach to assess these effects.

Purpose of the Study:

  • To evaluate the impact of common intensive care unit (ICU) practices on glucose levels in critically ill pediatric patients.
  • To utilize a continuous glucose monitoring (CGM) system to track glucose fluctuations during various interventions.
  • To determine if patient consciousness level influences glucose response to interventions.

Main Methods:

  • Seventeen CGM sensors were applied to 16 pediatric patients.
  • Therapeutic and diagnostic interventions were recorded, with glucose measurements taken 15 minutes post-intervention.
  • Glucose difference was calculated relative to each patient's daily mean, and patient consciousness (awake vs. sedated) was noted.

Main Results:

  • A total of 205 skin interventions and 649 respiratory interventions were analyzed.
  • Glucose levels were significantly higher in awake patients compared to sedated patients (P < .001).
  • Respiratory interventions like washings showed a greater glucose increase than simple suctions (P = .016).

Conclusions:

  • Diagnostic and therapeutic procedures in the ICU can significantly elevate glucose levels in pediatric patients.
  • The stress response, particularly in awake patients undergoing interventions, leads to a notable rise in blood glucose.
  • CGM provides valuable insights into glycemic changes associated with ICU care, highlighting the importance of patient state.
Abstract

Keywords:
childrencontinuous glucose monitoringflash glucose monitoringhyperglycemiaintensive care unitstress

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