Glycemic level in mechanically ventilated children with bronchiolitis.
OBJECTIVE
To evaluate in children with bronchiolitis requiring mechanical ventilation the association between blood glucose level and duration of mechanical ventilation and pediatric intensive care unit (PICU) stay.


METHODS
Retrospective cohort study.


METHODS
University hospital PICU.


METHODS
Children admitted to a university hospital PICU over a period of 3 yrs.


METHODS
None.


RESULTS
Demographic data, infection with respiratory syncytial virus, history of prematurity, mechanical ventilator settings, and use of inotrope during illness were noted. In addition, C-reactive protein, alanine transaminase, and glucose levels were recorded. Data from 50 children with median (interquartile range) age of 2.2 (1.3-4.7) months were analyzed. There were 37 boys, 21 children had been premature babies, and 30 children were positive for respiratory syncytial virus. Hyperglycemia at any time was frequent (peak glucose > or =6.1 mmol/L [110 mg/dL] in 98% and >8.3 mmol/L [150 mg/dL] in 72%). Children with sustained hyperglycemia were more likely to be boys with higher alanine transaminase and C-reactive protein, requiring inotrope (p < .05). These children are more likely to have required high-frequency oscillation ventilation, required higher airway pressures, and had longer duration of mechanical ventilation and PICU stay (p < .05). Peak glucose and sustained peak glucose were not independently associated with duration of mechanical ventilation or PICU stay. Multiple regression showed that age, C-reactive protein, the need for inotrope, and respiratory syncytial virus infection were independent factors associated with duration of PICU stay. Glucose level was not a factor.


CONCLUSIONS
Our findings show that hyperglycemia is frequent in children with bronchiolitis requiring mechanical ventilation, but we failed to show that this phenomenon was independently associated with prolonged duration of mechanical ventilation or PICU stay. Our observations raise the question whether tight glycemic control should be used in children with bronchiolitis.
Branco
Ricardo G
RG
Department of Paediatrics, University of Cambridge School of Medicine, Addenbrookes Hospital, Cambridge, UK. brancori@terra.com.br
Tasker
Robert C
RC
D001786:Blood Glucose / Q000032:analysis*; D001990:Bronchiolitis, Viral / Q000150:complications / Q000175:diagnosis*; D002675:Child, Preschool; D015331:Cohort Studies; D016638:Critical Illness; D004739:England; D005260:Female; D038321:Glycemic Index; D006785:Hospitals, University; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013222:State Medicine; D006113:United Kingdom
D001786:Blood Glucose