Etiology of Hyperglycemia in Critically Ill Children and the Impact of Organ Dysfunction

Overview

Journal Rev Bras Ter Intensiva

Specialties Critical Care
General Medicine

Date 2018 Oct 18

PMID 30328985

Citations 4

Authors

Seham Awad El-Sherbini

Huda Marzouk

Riham El-Sayed

Sarah Hosam-ElDin

Affiliations

Soon will be listed here.

Abstract

Objective: This study aimed to study the incidence of stress hyperglycemia in critically ill children and to investigate the etiological basis of the hyperglycemia based on homeostasis model assessment.

Methods: This was a prospective cohort study in one of the pediatric intensive care units of Cairo University, including 60 critically ill children and 21 healthy controls. Serum blood glucose, insulin, and C-peptide levels were measured within 24 hours of admission. Homeostasis model assessment was used to assess β-cell function and insulin sensitivity.

Results: Hyperglycemia was estimated in 70% of patients. Blood glucose values ≥ 180mg/dL were associated with a poor outcome. Blood glucose levels were positively correlated with Pediatric Risk for Mortality (PRISM III) score and number of organ dysfunctions (p = 0.019 and p = 0.022, respectively), while insulin levels were negatively correlated with number of organ dysfunctions (r = -0.33, p = 0.01). Homeostasis model assessment revealed that 26 (43.3%) of the critically ill patients had low β-cell function, and 18 (30%) had low insulin sensitivity. Combined pathology was detected in 2 (3.3%) patients only. Low β-cell function was significantly associated with the presence of multi-organ dysfunction; respiratory, cardiovascular, and hematological dysfunctions; and the presence of sepsis.

Conclusions: β-Cell dysfunction appeared to be prevalent in our cohort and was associated with multi-organ dysfunction.

Citing Articles

Prevalence and Prognostic Factors of Stress Hyperglycemia in a Pediatric Population with Acute Illness in Greece-A Prospective Observational Study.

Korakas E, Argyropoulos T, Koliou G, Gikas A, Kountouri A, Nikolopoulou S J Clin Med. 2022; 11(5).

PMID: 35268392 PMC: 8911079. DOI: 10.3390/jcm11051301.

Impaired Pancreatic β-Cell Function in Critically Ill Children.

Mohamed S, Badawi N, Abdelrasol H, Abdelaziz H, Khalaf N, Yousef R Front Pediatr. 2021; 9:603361.

PMID: 33869110 PMC: 8044972. DOI: 10.3389/fped.2021.603361.

The Effect of Various, Everyday Practices on Glucose Levels in Critically Ill Children.

Tsotridou E, Kotzapanagiotou E, Violaki A, Dimitriadou M, Svirkos M, Mantzafleri P J Diabetes Sci Technol. 2020; 16(1):81-87.

PMID: 33025823 PMC: 8875055. DOI: 10.1177/1932296820959315.

Outcomes Associated With Multiple Organ Dysfunction Syndrome in Critically Ill Children With Hyperglycemia.

Marsillio L, Asaro L, Srinivasan V, Wypij D, Sorce L, Agus M Pediatr Crit Care Med. 2019; 20(12):1147-1156.

PMID: 31688812 PMC: 6895434. DOI: 10.1097/PCC.0000000000002151.

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