Prevalence of dysglycemia and association with outcomes in pediatric extracorporeal membrane oxygenation.
Pediatr Crit Care Med
; 16(3): 270-5, 2015 Mar.
Article
en En
| MEDLINE
| ID: mdl-25560426
ABSTRACT
OBJECTIVES:
To evaluate the relationship between glucose derangement, insulin administration, and mortality among children on extracorporeal membrane oxygenation.DESIGN:
Retrospective cohort.SETTING:
Tertiary PICU. PATIENTS Two hundred nine children receiving extracorporeal membrane oxygenation, including 97 neonates.INTERVENTIONS:
None. MEASUREMENTS AND MAINRESULTS:
Hyperglycemia and severe hyperglycemia were defined as a single blood glucose level greater than 15 mmol/L (270 mg/dL) and greater than 20 mmol/L (360 mg/dL), respectively. Hypoglycemia and severe hypoglycemia were defined as any single glucose level less than 3.3 mmol/L (60 mg/dL) and less than 2.2 mmol/L (40 mg/dL), respectively. A total of 15,912 glucose values were recorded. The median number of glucose values was 59 per patient, corresponding to a mean 0.53 ± 0.12 tests per hour. Sixty-nine patients (33.0%) without dysglycemia and who received no insulin were defined as the control group. Eighty-nine (42.6%) and 26 (12.4%) patients developed hyperglycemia and severe hyperglycemia, respectively. Sixty-three (30.1%) and 17 (8.1%) patients developed hypoglycemia and severe hypoglycemia, respectively. Sixty-one patients (29.2%) received IV insulin during extracorporeal membrane oxygenation. Both hyperglycemia and hypoglycemia were associated with increased mortality on extracorporeal membrane oxygenation (46% and 48%, respectively, vs 29% of controls; p = 0.03). However, after adjusting for severity of illness and extracorporeal membrane oxygenation complications, abnormal glucose levels were not independently related to mortality.CONCLUSIONS:
Dysglycemia in children on extracorporeal membrane oxygenation was common but not independently associated with increased mortality. The optimal glucose range for this high-risk population requires further investigation.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Glucemia
/
Oxigenación por Membrana Extracorpórea
/
Hiperglucemia
/
Hipoglucemia
Tipo de estudio:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
Idioma:
En
Revista:
Pediatr Crit Care Med
Asunto de la revista:
PEDIATRIA
/
TERAPIA INTENSIVA
Año:
2015
Tipo del documento:
Article
País de afiliación:
Eslovenia