title: Assessment of blood glucose control in the pediatric intensive care unit: extension of the glycemic penalty index toward children and infants.
abstract: BACKGROUND
  The glycemic penalty index (GPI) is a measure to assess blood glucose (BG) control in critically ill adult patients but needs to be adapted for children and infants.
  
  
  METHODS
  The squared differences between a clinical expertise penalty function and the corresponding polynomial function are minimized for optimization purposes. The average of all penalties (individually assigned to all BG readings) represents the patient-specific GPI.
  
  
  RESULTS
  Penalization in the hypoglycemic range is more severe than in the hyperglycemic range as the developing brains of infants and children may be more vulnerable to hypoglycemia. Similarly, hypoglycemia is also more heavily penalized in infants than in children.
  
  
  CONCLUSIONS
  Extending the adult GPI toward the age-specific GPI is an important methodological step. Long-term clinical studies are needed to determine the clinically acceptable GPI cut-off level.
authors.affiliation: Department of Intensive Care Medicine, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium. tom.vanherpe@esat.kuleuven.be
authors.forename: Tom
authors.initials: T
authors.lastname: Van Herpe
authors.forename: Marijke
authors.initials: M
authors.lastname: Gielen
authors.forename: Koen
authors.initials: K
authors.lastname: Vanhonsebrouck
authors.forename: Pieter J
authors.initials: PJ
authors.lastname: Wouters
authors.forename: Greet
authors.initials: G
authors.lastname: Van den Berghe
authors.forename: Bart
authors.initials: B
authors.lastname: De Moor
authors.forename: Dieter
authors.initials: D
authors.lastname: Mesotten
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D015233:Models, Statistical; D008991:Monitoring, Physiologic / Q000379:methods; D012016:Reference Values
chemical_list: D001786:Blood Glucose