title: Organ dysfunction is associated with hyperglycemia in critically ill children.
abstract: OBJECTIVE
  To determine the association between organ dysfunction and hyperglycemia in critically ill children receiving intravenous insulin.
  
  
  METHODS
  Retrospective chart review (cohort study).
  
  
  METHODS
  Pediatric intensive care unit in a university hospital.
  
  
  METHODS
  n = 110 patients; inclusion criteria: ICU hospitalization from May 2005 to May 2006; insulin drip to manage hyperglycemia.
  
  
  METHODS
  insulin drip <48 h; diabetic patients.
  
  
  METHODS
  Duration of hyperglycemia: sum of hours of hyperglycemia (> or =126 mg/dl). Hypoglycemia (blood glucose <40 mg/dl). Organ dysfunction was determined per International Pediatric Sepsis Consensus Conference criteria. Multiple logistic regression models determined the association between > or =3 compared to <3 organ dysfunctions and hyperglycemia, hypoglycemia, and mortality, after adjustment for confounding variables (age, gender, PRISM score, vasopressors, steroids).
  
  
  RESULTS
  Organ dysfunction > or =3 compared to <3 after adjustment for confounders was associated with intermittent hyperglycemia of > or =24 h (OR 6.1, CI 1.8-21.2; p = 0.004). Hyperglycemia trended towards significance with mortality [3.2 (CI 0.9-11.6, p = 0.079)]. Hypoglycemia, after adjusting for the above, was not associated with mortality.
  
  
  CONCLUSIONS
  Organ dysfunction (> or =3 versus <3) was significantly associated with hyperglycemia for > or =24 h and hypoglycemia. Hyperglycemia trended toward significance with mortality in critically ill children. There was no association between hypoglycemia and mortality.
authors.affiliation: Pediatric Critical Care Medicine, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin, WT6-006, Houston, Texas 77030, USA. ukyle@bcm.tmc.edu
authors.forename: Ursula G
authors.initials: UG
authors.lastname: Kyle
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Coss Bu
authors.forename: Curtis E
authors.initials: CE
authors.lastname: Kennedy
authors.forename: Larry S
authors.initials: LS
authors.lastname: Jefferson
mesh_terms: D001786:Blood Glucose; D002648:Child; D016638:Critical Illness; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology*; D008297:Male; D009102:Multiple Organ Failure / Q000453:epidemiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D001786:Blood Glucose