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Prognostic Value of Serum Glucose Level in Critically Ill Septic Patients on Admission to Pediatric Intensive Care

Aya Osama Mohamed1, Mohamed Abdallah Abd El-Megied1, Yomna Ahmed Hosni1

  • 1Department of Pediatrics, Faculty of Medicine, Cairo University, Maadi, Giza, Egypt.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|November 1, 2023
PubMed

Insights

Sepsis in the pediatric intensive care unit (PICU) is linked to blood glucose variations. Abnormal random blood glucose levels, especially hypoglycemia, indicate a poorer prognosis and higher mortality risk in septic children.

Area of Science:

  • Pediatric critical care medicine
  • Endocrinology
  • Infectious diseases

Background:

  • Sepsis is a leading cause of pediatric intensive care unit (PICU) admission and adverse outcomes.
  • Sepsis can disrupt glucose homeostasis, leading to hypoglycemia or hyperglycemia.
  • Random blood glucose (RBG) measurement is a simple tool for assessing prognosis in septic pediatric patients.

Purpose of the Study:

  • To evaluate the association between blood glucose levels upon admission to the PICU and the outcomes of pediatric septic patients.
  • To determine if RBG measurement can serve as an early prognostic indicator in pediatric sepsis.

Main Methods:

  • A prospective study involving 103 children diagnosed with sepsis admitted to the PICU.
  • Clinical assessment, initial laboratory tests including RBG, and calculation of Pediatric Sequential Organ Failure Assessment (pSOFA) scores were performed.
  • Patient outcomes, including length of stay, systemic review, and mortality, were documented.

Main Results:

  • Hypoglycemic patients exhibited the highest non-survival rate (20.4%).
  • Hypoglycemia was associated with significantly higher pSOFA scores, shorter PICU stays, lower RBG levels, and increased need for ventilation and inotropic support (p < 0.001).

Conclusions:

  • Abnormal random blood sugar levels in critically ill septic children are linked to increased mortality risk, particularly in cases of hypoglycemia.
  • RBG measurement is a rapid, inexpensive, and effective method for early outcome prediction in pediatric sepsis.
Abstract

Keywords:
ChildrenHypoglycemiaMortalitySepsis

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