title: Prospective detection of hyperglycemia in critically ill children using continuous glucose monitoring.
abstract: OBJECTIVE
  To evaluate the extent of hyperglycemia in nondiabetic children admitted to a pediatric intensive care unit using an interstitial continuous glucose monitor, and to compare the ability of this interstitial continuous glucose monitoring system to detect hyperglycemia with that of intermittent laboratory monitoring.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Ten-bed pediatric intensive care unit in an academic referral medical center in western Massachusetts.
  
  
  METHODS
  A convenience sample of 20 nondiabetic children, aged 1-18, anticipated to require intensive care >2 days.
  
  
  METHODS
  Placement of a subcutaneous continuous glucose monitor for 72 hrs with a subsequent second sensor placed if the patient and family agreed. Glucose levels were compared with laboratory glucose values.
  
  
  RESULTS
  Elevated glucose levels were revealed by 16,337 sensor glucose readings over a mean of 68 +/- 5.2 hrs per patient. Forty-three percent of readings were >125 mg/dL (6.9 mmol/L), 27.2% were >140 mg/dL (7.8 mmol/L), and 4.0% were >200 mg/dL (11.1 mmol/L). Laboratory glucose measurements demonstrated hyperglycemia less frequently and missed significant periods of hyperglycemia.
  
  
  CONCLUSIONS
  Significant hyperglycemia is present in pediatric intensive care patients and may be underestimated by intermittent laboratory monitoring.
authors.affiliation: Baystate Children's Hospital. holley.allen@bhs.org
authors.forename: Holley F
authors.initials: HF
authors.lastname: Allen
authors.forename: Alyssa
authors.initials: A
authors.lastname: Rake
authors.forename: Marybeth
authors.initials: M
authors.lastname: Roy
authors.forename: Dennis
authors.initials: D
authors.lastname: Brenner
authors.forename: Christine A
authors.initials: CA
authors.lastname: McKiernan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D005947:Glucose / Q000032:analysis*; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis* / Q000453:epidemiology; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods; D011446:Prospective Studies
chemical_list: D005947:Glucose