The relationship between the blood glucose level and critical illness in children
10.3760/cma.j.issn.1671-0282.2012.05.009
- VernacularTitle:重症患儿血糖监测与危重度关系的研究
- Author:
Pingping LIU
;
Zhiyue XU
;
Xiulan LU
;
Meiyu YANG
;
Yimin ZHU
- Publication Type:Journal Article
- Keywords:
Critical condition;
Hyperglycemia;
Children;
Severity
- From:
Chinese Journal of Emergency Medicine
2012;21(5):478-483
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical features and prognosis of hyperglycemia and the relationship between the blood glucose level and the severity of disease in critically ill children.Methods A total of 349 critically ill children admitted in Pediatric Intensive Care Unit (PICU) from November 2009 to April 2010 were restrospectively analyzed.According to the levels of venous blood glucose within 24 h after admission,they were divided into very high level group (blood glucose ≥11.1 mmol/L,n =67 ),slightly high level group (blood glucose 6.3-11.1 mmol/L,n =134) and normal level group (blood glucose ≤6.3mmol/L,n =148).Blood glucose levels were measured within 24 hours,3 days and 7 days after admission.Electrolytes,inflammatory markers,cardiac enzymes,liver and kidney function as well as other biomarkers related to the severity and the prognosis of the patients were recorded after admission.The categorical variables were analyzed with Chi -squared test,the continuous variables were analyzed with t-test,F-test,U-test andH-test,and the correlation analysis was calculated by using Pearson Coefficients. Results In the very high level group,slightly high level group and normal level group,the average blood glucose levels were 16.98 ±7.08 mmol/L,8.25 ± 1.40 mmol/L and 4.89 ± 0.98 mmol/L ( P ＜ 0.01 ),respectively;and the Pediatric Critical Ⅲ Scores at admission were 81.22 ± 8.25,86.71 ± 6.40 and 86.15 ± 6.99 ( P ＜0.01 ),respectively,and the incidences of sepsis or septic shock were 55.23％,30.59％ and 14.18％,respectively (P ＜0.01 ),and the incidences of MODS were 46.26％,22.39％ and 16.23％,respectively (P ＜0.01 ).The blood glucose levels of patients with one organ failure and two organ failure were 8.27 ± 3.75 mmol/L and 8.88 ± 5.42 mmol/L,respectively ( P ＜ 0.05 ).The blood glucose levels of patients with two organ failure and multiple organ failure were 8.88 ± 5.42 mmol/L and 13.09 ± 8.23 mmol/L,respectively (P＜0.01).The mortality rates of three groups were 47.76％,14.93％ and 10.13％ (P ＜0.01 ),and the blood glucose levels at admission in survival group and death group were 7.57 ±4.11 mmol/L and 12.46 ± 8.17 mmol/L ( P ＜ 0.01 ).Conclusions Patients with hyperglycemia are often found in the PICU.It not only partially reflects the severity of the disease,but also serves as an important indicator for the prognosis.The blood glucose level is positively correlated to the number of compromised organs and the severity of the disease.Dynamic monitoring of blood glucose may be essential for controlling the symptoms and prediction of prognosis.
