Retrospective outcomes of glucose control in critically ill children

Sarah B. Kandil, Debra Spear, Neal J. Thomas, Stuart A. Weinzimer, Edward Vincent S Faustino

Research output: Contribution to journalArticle

Abstract

Background: Hyperglycemia is a significant problem for critically ill children. Treatment for hyperglycemia remains controversial. This study explores the efect of controlling blood glucose (BG) in hyperglycemic critically ill children. Methods: A retrospective cohort of nondiabetic critically ill children (defined as requiring mechanical ventilation and/or vasopressors) with BG persistently ≥150 mg/dl and treated with insulin (treatment group) were compared with a historical cohort of similar children who did not receive interventions to control hyperglycemia (baseline group). Results: There were 130 children in the treatment group and 137 children in the baseline group. Mean BG in the treatment group was 140 ± 24 mg/dl compared with 179 ± 47 mg/dl in the baseline group (p < .001). A fter a djusting f or patient characteristics, cointerventions, and glucose metrics, patients in the treatment group had 2.5 fewer intensive care unit (ICU)-free days (i.e., number of days alive and discharged from ICU within 28 days after inclusion) than the baseline group (p = .023). G lucose c ontrol was n ot i ndependently a ssociated w ith duration of ICU stay, ventilator-free days, vasopressor-free days, or mortality. Conclusions: Blood glucose control appears associated with worse outcomes in critically ill children. Our data combined with conflicting results in adults leads us to strongly advocate for the conduct of randomized trials on glucose control in critically ill children.

Original languageEnglish (US)
Pages (from-to)1220-1228
Number of pages9
JournalJournal of Diabetes Science and Technology
Volume7
Issue number5
DOIs
StatePublished - Jan 1 2013

Fingerprint

Critical Illness
Intensive care units
Glucose
Blood Glucose
Blood
Hyperglycemia
Intensive Care Units
Insulin
Therapeutics
Mechanical Ventilators
Artificial Respiration
Mortality

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Bioengineering
  • Biomedical Engineering

Cite this

Kandil, Sarah B. ; Spear, Debra ; Thomas, Neal J. ; Weinzimer, Stuart A. ; Faustino, Edward Vincent S. / Retrospective outcomes of glucose control in critically ill children. In: Journal of Diabetes Science and Technology. 2013 ; Vol. 7, No. 5. pp. 1220-1228.
@article{23850ce815f74c17a3d79a3a164912bf,
title = "Retrospective outcomes of glucose control in critically ill children",
abstract = "Background: Hyperglycemia is a significant problem for critically ill children. Treatment for hyperglycemia remains controversial. This study explores the efect of controlling blood glucose (BG) in hyperglycemic critically ill children. Methods: A retrospective cohort of nondiabetic critically ill children (defined as requiring mechanical ventilation and/or vasopressors) with BG persistently ≥150 mg/dl and treated with insulin (treatment group) were compared with a historical cohort of similar children who did not receive interventions to control hyperglycemia (baseline group). Results: There were 130 children in the treatment group and 137 children in the baseline group. Mean BG in the treatment group was 140 ± 24 mg/dl compared with 179 ± 47 mg/dl in the baseline group (p < .001). A fter a djusting f or patient characteristics, cointerventions, and glucose metrics, patients in the treatment group had 2.5 fewer intensive care unit (ICU)-free days (i.e., number of days alive and discharged from ICU within 28 days after inclusion) than the baseline group (p = .023). G lucose c ontrol was n ot i ndependently a ssociated w ith duration of ICU stay, ventilator-free days, vasopressor-free days, or mortality. Conclusions: Blood glucose control appears associated with worse outcomes in critically ill children. Our data combined with conflicting results in adults leads us to strongly advocate for the conduct of randomized trials on glucose control in critically ill children.",
author = "Kandil, {Sarah B.} and Debra Spear and Thomas, {Neal J.} and Weinzimer, {Stuart A.} and Faustino, {Edward Vincent S}",
year = "2013",
month = "1",
day = "1",
doi = "10.1177/193229681300700512",
language = "English (US)",
volume = "7",
pages = "1220--1228",
journal = "Journal of diabetes science and technology",
issn = "1932-2968",
publisher = "Diabetes Technology Society",
number = "5",

}

Retrospective outcomes of glucose control in critically ill children. / Kandil, Sarah B.; Spear, Debra; Thomas, Neal J.; Weinzimer, Stuart A.; Faustino, Edward Vincent S.

In: Journal of Diabetes Science and Technology, Vol. 7, No. 5, 01.01.2013, p. 1220-1228.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Retrospective outcomes of glucose control in critically ill children

AU - Kandil, Sarah B.

AU - Spear, Debra

AU - Thomas, Neal J.

AU - Weinzimer, Stuart A.

AU - Faustino, Edward Vincent S

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Background: Hyperglycemia is a significant problem for critically ill children. Treatment for hyperglycemia remains controversial. This study explores the efect of controlling blood glucose (BG) in hyperglycemic critically ill children. Methods: A retrospective cohort of nondiabetic critically ill children (defined as requiring mechanical ventilation and/or vasopressors) with BG persistently ≥150 mg/dl and treated with insulin (treatment group) were compared with a historical cohort of similar children who did not receive interventions to control hyperglycemia (baseline group). Results: There were 130 children in the treatment group and 137 children in the baseline group. Mean BG in the treatment group was 140 ± 24 mg/dl compared with 179 ± 47 mg/dl in the baseline group (p < .001). A fter a djusting f or patient characteristics, cointerventions, and glucose metrics, patients in the treatment group had 2.5 fewer intensive care unit (ICU)-free days (i.e., number of days alive and discharged from ICU within 28 days after inclusion) than the baseline group (p = .023). G lucose c ontrol was n ot i ndependently a ssociated w ith duration of ICU stay, ventilator-free days, vasopressor-free days, or mortality. Conclusions: Blood glucose control appears associated with worse outcomes in critically ill children. Our data combined with conflicting results in adults leads us to strongly advocate for the conduct of randomized trials on glucose control in critically ill children.

AB - Background: Hyperglycemia is a significant problem for critically ill children. Treatment for hyperglycemia remains controversial. This study explores the efect of controlling blood glucose (BG) in hyperglycemic critically ill children. Methods: A retrospective cohort of nondiabetic critically ill children (defined as requiring mechanical ventilation and/or vasopressors) with BG persistently ≥150 mg/dl and treated with insulin (treatment group) were compared with a historical cohort of similar children who did not receive interventions to control hyperglycemia (baseline group). Results: There were 130 children in the treatment group and 137 children in the baseline group. Mean BG in the treatment group was 140 ± 24 mg/dl compared with 179 ± 47 mg/dl in the baseline group (p < .001). A fter a djusting f or patient characteristics, cointerventions, and glucose metrics, patients in the treatment group had 2.5 fewer intensive care unit (ICU)-free days (i.e., number of days alive and discharged from ICU within 28 days after inclusion) than the baseline group (p = .023). G lucose c ontrol was n ot i ndependently a ssociated w ith duration of ICU stay, ventilator-free days, vasopressor-free days, or mortality. Conclusions: Blood glucose control appears associated with worse outcomes in critically ill children. Our data combined with conflicting results in adults leads us to strongly advocate for the conduct of randomized trials on glucose control in critically ill children.

UR - http://www.scopus.com/inward/record.url?scp=84900537060&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84900537060&partnerID=8YFLogxK

U2 - 10.1177/193229681300700512

DO - 10.1177/193229681300700512

M3 - Article

VL - 7

SP - 1220

EP - 1228

JO - Journal of diabetes science and technology

JF - Journal of diabetes science and technology

SN - 1932-2968

IS - 5

ER -