title: Insulin therapy in hyperglycemic children with severe acute asthma.
abstract: OBJECTIVE
  The aim of this study was to assess the effect of intravenous (IV) insulin administration in children with severe acute asthma (SAA) and hyperglycemia on IV salbutamol consumption and length of stay (LOS) in a pediatric intensive care unit (PICU).
  
  
  METHODS
  Retrospective, descriptive study of the clinical course before and after implementation of an insulin protocol for the treatment of hyperglycemia (i.e. blood glucose >8 mmol/L or 144 mg/dL, respectively) in the PICU of a tertiary care university hospital. Admissions between 1994 and 2010 were reviewed. The insulin protocol was introduced in 2006.
  
  
  RESULTS
  A total of 131 pediatric patients with SAA complicated by hyperglycemia requiring IV salbutamol were included. Severity of illness before and after implementation of the insulin protocol did not significantly differ. The insulin-treated patient group had significantly higher maximum blood glucose levels and higher cumulative IV salbutamol dose than the non-treated group. There were no differences between these groups in the duration of IV salbutamol administration and LOS.
  
  
  CONCLUSIONS
  In view of the lack of difference in outcomes and considering that the insulin protocol is labor-intensive, the question is whether this protocol is efficacious for the treatment of pediatric SAA associated with hyperglycemia.
authors.affiliation: a Department of Pediatric Intensive Care .
authors.forename: Suzan C M
authors.initials: SC
authors.lastname: Cochius-den Otter
authors.forename: Koen F M
authors.initials: KF
authors.lastname: Joosten
authors.forename: Johan C
authors.initials: JC
authors.lastname: de Jongste
authors.forename: Wim C J
authors.initials: WC
authors.lastname: Hop
authors.forename: Matthijs
authors.initials: M
authors.lastname: de Hoog
authors.forename: Corinne M P
authors.initials: CM
authors.lastname: Buysse
mesh_terms: D000208:Acute Disease; D061605:Administration, Intravenous; D000293:Adolescent; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001786:Blood Glucose; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007223:Infant; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D015278:Intensive Care Units, Pediatric; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D001786:Blood Glucose; D001993:Bronchodilator Agents; D007004:Hypoglycemic Agents; D007328:Insulin; D000420:Albuterol
keywords: Child; insulin infusion; intensive care; intravenous salbutamol