Association of timing, duration, and intensity of hyperglycemia with intensive care unit mortality in critically ill children.

Publication/Presentation Date

7-1-2004

Abstract

OBJECTIVE: To study the association of timing, duration, and intensity of hyperglycemia with pediatric intensive care unit (PICU) mortality in critically ill children.

DESIGN: Retrospective cohort study.

SETTING: PICU of a university-affiliated, tertiary care, children's hospital.

PATIENTS: A total of 152 critically ill children receiving vasoactive infusions or mechanical ventilation.

INTERVENTIONS: None.

METHODS: With institutional review board approval, we reviewed a cohort of 179 consecutive children, 1 mo to 21 yrs of age, treated with mechanical ventilation or vasoactive infusions. We excluded 18 with <3 >microg.kg(-1).min(-1) dopamine only, diabetes, or solid organ transplant and nine who died within 24 hrs of PICU admission. Peak blood glucose (BG) and time to peak BG during PICU admission, duration of hyperglycemia (percentage of PICU days with any BG of >126 mg/dL), and intensity of hyperglycemia (median BG during first 48 PICU hours) were analyzed for association with PICU mortality using chi-square, Student's t-test, and logistic regression.

MEASUREMENTS AND MAIN RESULTS: Peak BG of >126 mg/dL occurred in 86% of patients. Compared with survivors, nonsurvivors had higher peak BG (311 +/- 115 vs. 205 +/- 80 mg/dL, p

CONCLUSIONS: Hyperglycemia is common in critically ill children. Peak BG and duration of hyperglycemia are independently associated with mortality in our PICU. A prospective, randomized trial of strict glycemic control in this subset of critically ill children who are at high risk of mortality is both warranted and feasible.

Volume

5

Issue

4

First Page

329

Last Page

336

ISSN

1529-7535

Disciplines

Medicine and Health Sciences | Pediatrics

PubMedID

15215001

Department(s)

Department of Pediatrics

Document Type

Article

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