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https://doi.org/10.1097/PCC.0000000000000304
Title: | Prevalence of Dysglycemia and Association With Outcomes in Pediatric Extracorporeal Membrane Oxygenation | Authors: | Lou S. MacLaren G Paul E. Best D. Delzoppo C. Butt W. |
Keywords: | extracorporeal life support hyperglycemia hypoglycemia insulin |
Issue Date: | 2015 | Publisher: | Lippincott Williams and Wilkins | Citation: | Lou S., MacLaren G, Paul E., Best D., Delzoppo C., Butt W. (2015). Prevalence of Dysglycemia and Association With Outcomes in Pediatric Extracorporeal Membrane Oxygenation. Pediatric Critical Care Medicine 16 (3) : 270-275. ScholarBank@NUS Repository. https://doi.org/10.1097/PCC.0000000000000304 | Abstract: | Objectives: To evaluate the relationship between glucose derangement, insulin administration, and mortality among children on extracorporeal membrane oxygenation. Design: Retrospective cohort. Setting: Tertiary PICU. Patients: Two hundred nine children receiving extracorporeal membrane oxygenation, including 97 neonates. Interventions: None. Measurements and Main Results: Hyperglycemia and severe hyperglycemia were defined as a single blood glucose level greater than 15 mmol/L (270 mg/dL) and greater than 20 mmol/L (360 mg/dL), respectively. Hypoglycemia and severe hypoglycemia were defined as any single glucose level less than 3.3 mmol/L (60 mg/dL) and less than 2.2 mmol/L (40 mg/dL), respectively. A total of 15,912 glucose values were recorded. The median number of glucose values was 59 per patient, corresponding to a mean 0.53 � 0.12 tests per hour. Sixty-nine patients (33.0%) without dysglycemia and who received no insulin were defined as the control group. Eighty-nine (42.6%) and 26 (12.4%) patients developed hyperglycemia and severe hyperglycemia, respectively. Sixty-three (30.1%) and 17 (8.1%) patients developed hypoglycemia and severe hypoglycemia, respectively. Sixty-one patients (29.2%) received IV insulin during extracorporeal membrane oxygenation. Both hyperglycemia and hypoglycemia were associated with increased mortality on extracorporeal membrane oxygenation (46% and 48%, respectively, vs 29% of controls; p = 0.03). However, after adjusting for severity of illness and extracorporeal membrane oxygenation complications, abnormal glucose levels were not independently related to mortality. Conclusions: Dysglycemia in children on extracorporeal membrane oxygenation was common but not independently associated with increased mortality. The optimal glucose range for this high-risk population requires further investigation. Copyright � 2015 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. | Source Title: | Pediatric Critical Care Medicine | URI: | https://scholarbank.nus.edu.sg/handle/10635/162660 | ISSN: | 15297535 | DOI: | 10.1097/PCC.0000000000000304 |
Appears in Collections: | Staff Publications |
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