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危急疾病和严格血糖控制治疗后4年的儿童的神经认知发育:随机对照试验
Dieter Mesotten1, Marijke Gielen, Caroline Sterken
1Department of Intensive Care Medicine, Catholic University of Leuven, Leuven, Belgium.
JAMA
|October 27, 2012
概括
在儿科重症监护中的严格血糖控制 (TGC) 不会损害长期的神经发育. 这种方法虽然增加了低血糖症,但没有对儿童的智力或整体结果产生不良影响.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 神经发育结果的结果
- 葡萄糖管理 葡萄糖管理
背景情况:
- 在儿科重症监护中,严格的血糖控制 (TGC) 降低了发病率和死亡率,但增加了低血糖症.
- 人们担心高血糖和低血糖对发育中的大脑的潜在不良影响.
研究的目的:
- 评估在ICU中接受TGC治疗的儿童的长期神经发育结果.
- 验证TGC的短期好处,并排除潜在的危害.
主要方法:
- 这是一项前性随机对照试验,涉及700名儿科ICU患者.
- 3年后的长期随访,评估智力 (IQ),视觉运动一体化,注意力,运动协调,执行功能,记忆力和行为.
- 与健康的兄弟姐妹和不相关的孩子进行比较.
主要成果:
- TGC并没有影响全面的智商分数,也没有增加不良结果 (死亡或严重残疾) 的发生率.
- 在TGC和通常护理 (UC) 组之间,在智力,视觉运动整合或记忆方面没有观察到差异.
- TGC显著改善了运动协调和认知灵活性.
结论:
- 与接受UC治疗的儿童相比,在ICU中接受TGC治疗的儿童在随访时没有表现出更糟糕的智力指标.
- 由TGC引起的短暂低血糖症与不良的神经认知结果无关.
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