An Analysis of Hyperglycemia & it’s association with other parameters in Critically ill Paediatric Patients

Abstract

Introduction : With increasing facilities for intensive care becoming available in India, a large number of  Intensivists along with pediatricians are looking after critically ill children. The prevalence, consequences and management of hypoglycemia have been highlighted in pediatric literature but there is a lack of awareness regarding the prevalence and adverse effects of hyperglycemia among sick children. Study was conducted to determine the incidence and association of hyperglycemia with outcome of critically ill childrens. Methods:This Retrospective Analytical  study involvd 100 paediatric patients who were grouped as hyperglycemic and non-hyperglycemic . Two groups were compared with each other with demographic variables like age, sex, weight, admission symptoms, nutritional status, final diagnosis, and vital signs at admission. Critical care illness variable like use of inotrope agents, requirement of mechanical ventilation, duration of ventilation, duration of stay in PICU, and final outcome was compared.Results:Both groups were comparable with respect to demographic variables like age, sex, weight, nutritional status, presenting complaints, disease pattern and severity of illness.Inotropic support , Mean stay in PICU & mortality was  significantly higher in hyperglycemics . Mechanical Airway support & PRISM II score and peak glucose levels were higher in Non Survivors Peak blood glucose level  and duration of hyperglycemia were independently associated with increased risk of death. Conclusion: We have demonstrated that hyperglycemia occurs commonly in critically ill children and may be associated with poor outcome, glycemic control may confer survival advantage as it does in adults. Prospective, randomized, controlled trials related to glucose control in these children are needed.