title: High glucose intake and glycaemic level in critically ill neonates with inherited metabolic disorders of intoxication.
abstract: To investigate glycaemic levels in critically ill neonates with inherited metabolic disorders of intoxication. Thirty-nine neonates with a median age of 7 days (0-24) were retrospectively included (urea cycle disorders (n = 18), maple syrup disease (n = 13), organic acidemias (n = 8)). Twenty-seven neonates were intubated, 21 were haemodialysed and 6 died. During the first 3 days, median total and peak blood glucose (BG) levels were 7.1 mmol/L (0.9-50) and 10 mmol/L (5.1-50), respectively. The median glucose intake rate was 11 mg/kg/min (2.7-15.9). Fifteen and 23 neonates exhibited severe hyperglycaemia (≥2 BG levels >12 mmol/L) and mild hyperglycaemia (≥2 BG levels >7 and ≤12 mmol/L), respectively. Glycaemic levels and number of hyperglycaemic neonates decreased over the first 3 days (p < 0.001) while total glucose intake rate was stable (p = 0.11). Enteral route of glucose intake was associated with a lower number of hyperglycaemic neonates (p = 0.04) and glycaemic level (p = 0.02).
  
  
  CONCLUSIONS
  Hyperglycaemia is common in critically ill neonates receiving high glucose intake with inherited metabolic disorders of intoxication. Physicians should decrease the rate of total glucose intake and begin enteral feeding as quickly as possible in cases of persistent hyperglycaemia.
  
  
  BACKGROUND
  • The risk of hyperglycaemia in the acute phase of critical illness is high. What is New: • Hyperglycaemia is common in the initial management of critically ill neonates with inherited metabolic disorders of intoxication receiving high glucose intake.
authors.affiliation: Pediatric Intensive Care Unit, Necker-Enfants-Malades Hospital, APHP, Paris-Descartes University, 149, Rue de Sèvres, 75743, Paris, Cedex 15, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Grimaud
authors.affiliation: Pediatric Metabolic Diseases Department, Necker-Enfants-Malades Hospital, APHP, Paris-Descartes University, Paris, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: de Lonlay
authors.affiliation: Pediatric Intensive Care Unit, Necker-Enfants-Malades Hospital, APHP, Paris-Descartes University, 149, Rue de Sèvres, 75743, Paris, Cedex 15, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Dupic
authors.affiliation: Pediatric Metabolic Diseases Department, Necker-Enfants-Malades Hospital, APHP, Paris-Descartes University, Paris, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Arnoux
authors.affiliation: Pediatric Metabolic Diseases Department, Necker-Enfants-Malades Hospital, APHP, Paris-Descartes University, Paris, France.
authors.forename: Anais
authors.initials: A
authors.lastname: Brassier
authors.affiliation: Pediatric Intensive Care Unit, Necker-Enfants-Malades Hospital, APHP, Paris-Descartes University, 149, Rue de Sèvres, 75743, Paris, Cedex 15, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Hubert
authors.affiliation: Pediatric Intensive Care Unit, Necker-Enfants-Malades Hospital, APHP, Paris-Descartes University, 149, Rue de Sèvres, 75743, Paris, Cedex 15, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Lesage
authors.affiliation: Pediatric Intensive Care Unit, Necker-Enfants-Malades Hospital, APHP, Paris-Descartes University, 149, Rue de Sèvres, 75743, Paris, Cedex 15, France. mehdi.oualha@aphp.fr.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Oualha
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D016638:Critical Illness; D004750:Enteral Nutrition / Q000379:methods; D005260:Female; D005947:Glucose / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced*; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008297:Male; D008661:Metabolism, Inborn Errors / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D005947:Glucose
keywords: Critical illness; Hyperglycaemia; Inherited metabolic disorders of intoxication; Neonates