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压力高血糖症和重症儿童的不良结果之间的关联是由高乳糖血症调节的
Wenjun Liu1, Milan Dong2, Jing Li1
1Department of Critical Care Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, China.
超乳糖血症 (HL) 在重症儿童中调节压力高血糖症 (SHG). 综合的SHG和HL预测了糟糕的结果,而单独的SHG则没有,这表明需要量身定制的葡萄糖目标.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 在危急疾病中代谢调节
- 儿科患者的生物标志物相互作用
背景情况:
- 在重症儿童中,关于最佳血糖控制的证据是矛盾的.
- 葡萄糖和乳酸盐水平之间的相互作用及其对儿科重症监护的结果的影响仍然不太清楚.
研究的目的:
- 调查超乳糖血症 (HL) 在改变压力高血糖 (SHG) 与不良结果之间的关联中的作用.
- 为严重病重的儿童制定个性化的葡萄糖管理策略提供信息.
主要方法:
- 在五个中国儿科重症监护病房 (PICU) 进行前性观察队列研究的二次分析.
- 检查了葡萄糖和乳酸指标对患者结局的相互作用效应.
- 定义的SHG是葡萄糖>150 mg/dL,HL是乳酸>2 mmol/L.
主要成果:
- 分析包括433名儿科患者和4885名血液气体测量;28天内死亡率为20.8%.
- 关于结果的SHG和HL之间的显著相互作用 (p < 0.05).
- 在HL的存在下,SHG独立预测了28天死亡率 (OR3.55) 和减少了无呼吸器和无ICU的日子. 单独使用SHG并不能预测死亡率或减少空日.
结论:
- 超乳糖血症似乎调节了压力高血糖和危急儿童的不良结果之间的关系.
- SHG和HL的组合与不良结果有关,而HL缺少的SHG则没有.
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