Glycemic abnormalities and their outcome in critically ill pediatric patients admitted in pediatric intensive care unit of tertiary care hospital

Abstract

Background: In normal healthy state, human body maintains homeostasis and normal glycemic levels, however in stress associated with any critical states, this control is impaired or lost. Hyperglycemia represents an extreme form of stress. There is no consensus about cut off blood glucose levels to be labeled as hyperglycemia in pediatric age group. Different studies considered different levels of blood glucose as hyperglycemia. Aims & Objectives: To determine frequency of glycemic abnormalities and to correlate this abnormalities with outcome in critically ill children admitted in Pediatric intensive care unit. Methodology: This was a prospective observational study. Total 61 number of cases in the age group of 1month to 17 years were enrolled in the study, by considering inclusion and exclusion criteria. Results: Out of 61 patients, 50.8% were females and 49.2% were males. Out of 61 patients, 73.8% had Hyperglycemia, 24.5% had Euglycemia, 1.6% patient had Hypoglycemia. There was a statistically significant association between hyperglycemia and those cases requiring mechanical ventilation and on vasopressors. Outcome was poor in those cases which had hyperglycemia and the risk of death was 5.78 times more in them. Conclusion: Prevalence of mean hyperglycemia was 80.3%, 72%, 31%, when cut off levels of blood glucose was considered as >126 mg/dl,>150 mg/dl, >200 mg/dl respectively. There was an increased morbidity and mortality in critically ill patients having hyperglycemia. As there are no definite cut off levels of hyperglycemia in critically ill patients, more studies and consensus is needed.