title: Control of serum glucose concentration in critical illness.
abstract: OBJECTIVE
  Hyperglycemia is a significant problem for children in the ICU. Use of tight glycemic control (TGC) to manage hyperglycemia remains controversial, especially given the potential risk of insulin-induced hypoglycemia. This review will address the latest evidence regarding TGC in critically ill children.
  
  
  RESULTS
  Two randomized controlled trials (RCT) involving primarily postoperative cardiac surgery patients demonstrated the feasibility and safety of TGC in pediatric patients. The trials, however, had discrepant results with regards to the benefit of TGC. There is also uncertainty about the generalizability of these results to nonpostoperative cardiac patients. There is only one published study addressing the long-term safety of TGC in children. In this study, hypoglycemia was not associated with adverse effects on neurocognitive development. In contrast, articles from adult studies demonstrate increased risk of death with hypoglycemia.
  
  
  CONCLUSIONS
  Although the clinical benefit of TGC in critically ill children is still unclear, TGC can be done safely in this population.
authors: Department of Pediatrics, Section of Pediatric Critical Care Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8064, USA. sarah.kandil@yale.edu
authors: Sarah B
authors: SB
authors: Kandil
authors: Michael
authors: M
authors: Miksa
authors: E Vincent S
authors: EV
authors: Faustino
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D016638:Critical Illness / Q000628:therapy*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000517:prevention & control; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents