title: Blood Glucose Variability and Outcomes in Critically Ill Children.
abstract: OBJECTIVE
  To find the incidence of hyperglycemia (blood glucose [BG] ≥150 mg/dl), hypoglycemia (BG ≤60 mg/dl), and variability (presence of hypoglycemia and hyperglycemia) in critically ill children in the 1stweek of Intensive Care Unit (ICU) stay and their association with mortality, length of ICU stay, and organ dysfunction.
  
  
  METHODS
  The design was a retrospective observational cohort study. Consecutive children ≤18 years of age admitted from March 2003 to April 2012 in a combined adult and pediatric closed ICU. Relevant data were collected from chart review and hospital database.
  
  
  RESULTS
  Out of 258 patients included, isolated hyperglycemia was seen in 139 (53.9%) and was unrelated to mortality and morbidity. Isolated variability in BG was noted in 76 (29.5%) patients and hypoglycemia was seen in 9 (3.5%) patients. BG variability was independently associated with multiorgan dysfunction syndrome on multivariate analysis (adjusted odds ratio [OR]: 7.1; 95% confidence interval [CI]: 1.6-31.1). Those with BG variability had longer ICU stay (11 days vs. 4 days, on log-rank test,P= 0.001). Insulin use was associated with the occurrence of variability (adjusted OR: 3.6; 95% CI: 1.8-7.0).
  
  
  CONCLUSIONS
  Glucose disorders were frequently observed in critically ill children. BG variability was associated with multiorgan dysfunction and increased ICU stay.
authors.affiliation: Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Kirti Mahadeorao
authors.initials: KM
authors.lastname: Naranje
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Banani
authors.initials: B
authors.lastname: Poddar
authors.affiliation: Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Arpita
authors.initials: A
authors.lastname: Bhriguvanshi
authors.affiliation: Department of Paediatric Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Richa
authors.initials: R
authors.lastname: Lal
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Afzal
authors.initials: A
authors.lastname: Azim
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Ratender K
authors.initials: RK
authors.lastname: Singh
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Mohan
authors.initials: M
authors.lastname: Gurjar
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Arvind K
authors.initials: AK
authors.lastname: Baronia
keywords: Blood glucose abnormalities; hyperglycemia; mortality; multiorgan dysfunction syndrome; variability