Patki Vinayak Krishnarao, Chougule Swati Balasaheb
Department of Pediatrics, Wanless Hospital Miraj, India.
Department of Pediatrics, Bharati Vidyapeeth University Medical College, Sangli, Maharashtra, India.
Indian J Crit Care Med. 2014 Jan;18(1):8-13. doi: 10.4103/0972-5229.125427.
To determine the incidence and study association of hyperglycemia with outcome of critically ill children.
This was a prospective observational study conducted in eight bedded pediatric intensive care unit (PICU) of a tertiary care hospital.
One hundred and one critically ill non-diabetic children between ages of 1 month to 16 years were studied from the day of admission till discharge or death. Serial blood sugars were determined first at admission, thereafter every 12 hourly in all children. Blood glucose level above 126 mg/dl (>7 mmol/dl) was considered as hyperglycemia. Children with hyperglycemia were followed 6 hourly till blood glucose fell below 126 mg/dl. Hyper and non-hyperglycemic children were compared with respect to length of stay, mechanical ventilation, use of inotrops and final outcome. Survivors and non-survivors were compared in relation to admission blood glucose, peak blood glucose level and duration of hyperglycemia.
Seventy (69.3%) children had hyperglycemia. Requirement of ventilation [(23) 32.9% vs.(3) 9.7%], requirement of inotropic support [(27) 38.6% vs.(5) 16.1%], Mean length of stay in PICU (7.91 ± 5.01 vs. 5.58 ± 1.95 days) and mortality (28.6% vs. 3.2%) among hyperglycemic children was significantly higher (P < 0.05) than that of non-hyperglycemic. Logistic regression analysis showed Peak blood glucose level and duration of hyperglycemia has independent association with increased risk of death.
Incidence of hyperglycemia is high in critically ill children and it is associated with high morbidity and mortality.
确定危重症儿童高血糖的发生率，并研究高血糖与危重症儿童预后的关系。
这是一项在一家三级医院设有8张床位的儿科重症监护病房（PICU）进行的前瞻性观察性研究。
对101名年龄在1个月至16岁之间的危重症非糖尿病儿童进行研究，从入院之日起直至出院或死亡。所有儿童入院时首先测定系列血糖，此后每12小时测定一次。血糖水平高于126mg/dl（>7mmol/dl）被视为高血糖。高血糖儿童每6小时监测一次，直至血糖降至126mg/dl以下。比较高血糖和非高血糖儿童的住院时间、机械通气情况、血管活性药物的使用情况及最终结局。比较存活者和非存活者的入院血糖、血糖峰值水平及高血糖持续时间。
70名（69.3%）儿童出现高血糖。高血糖儿童的通气需求[（23名）32.9%对（3名）|9.7%]、血管活性药物支持需求[（27名）38.6%对（5名）16.1%]、在PICU的平均住院时间（7.91±5.01天对5.58±1.95天）及死亡率（28.6%对3.2%）均显著高于非高血糖儿童（P<0.05）。逻辑回归分析显示，血糖峰值水平和高血糖持续时间与死亡风险增加独立相关。
危重症儿童高血糖发生率高，且与高发病率和高死亡率相关。
