Are recurrent hyperglycemic episodes and median blood glucose level a prognostic factor for increased morbidity and mortality in premature infants </=1500 g?
BACKGROUND
Tight blood glucose control with intravenous insulin reduces morbidity and mortality in adult surgical intensive care patients. This has never been investigated in premature infants weighing </=1500 g. We investigate the relationship between blood glucose levels repeatedly elevated >150 mg/dL and median blood glucose levels in the first week of life on one hand, and morbidity and mortality in premature infants weighing </=1500 g on the other.


METHODS
The following data were collected from 252 premature infants weighing </=1500 g at birth: demographic data, blood glucose levels at three set times during the day (capillary and arterial) in the first week of life, actual and relative elevation of blood glucose level >/=150 mg/dL, median blood glucose level, allocation of patients into groups according to number of elevated blood glucose levels >/=150 mg/dL (0, 1-3 or >/=4 incidents), and median blood sugar level in relation to mortality and morbidity like IVH, ROP, and sepsis.


RESULTS
A significant increase in mortality (P<0.0001) with increasing median blood glucose level and repeated (>/=4) incidents of blood glucose levels >/=150 mg/dL and in infants with low gestational age (<27 weeks) were observed. There was no correlation between blood glucose level and morbidity.


CONCLUSIONS
Premature infants with low gestational age (<27 weeks), elevated median blood glucose levels and/or repeatedly elevated blood glucose levels >/=150 mg/dL have a significantly increased mortality. However, further prospective studies considering the gestational age should determine the relationship between tight glucose control and mortality.
Heimann
Konrad
K
Department for Neonatal and Conservative Pediatric Intensive Care, University Hospital, Medical Faculty RWTH, Pauwelsstr. 30, D-52074 Aachen, Germany. kheimann@ukaachen.de
Peschgens
Thomas
T
Kwiecien
Robert
R
Stanzel
Sven
S
Hoernchen
Helmut
H
Merz
Ulrich
U
D001786:Blood Glucose / Q000032:analysis*; D005260:Female; D005858:Germany / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology* / Q000401:mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood / Q000453:epidemiology* / Q000401:mortality; D019102:Infant, Very Low Birth Weight; D008297:Male; D008499:Medical Records; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies
D001786:Blood Glucose