三级医院儿科重症监护病房重症患儿血糖异常及其结局

Gurudutt Joshi, Darshan Dholakia
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摘要

背景:在正常健康状态下,人体维持体内平衡和正常血糖水平,但在与应激相关的任何危急状态下,这种控制被破坏或丧失。高血糖症是压力的一种极端形式。在儿童年龄组中,关于将血糖水平降低标记为高血糖没有共识。不同的研究将不同的血糖水平视为高血糖症。目的和目的:确定儿科重症监护病房收治的危重儿童血糖异常的频率及其与预后的相关性。方法:这是一项前瞻性观察性研究。通过考虑纳入和排除标准,共纳入61例年龄在1个月至17岁的病例。结果:61例患者中,女性占50.8%,男性占49.2%。61例患者中高血糖占73.8%,低血糖占24.5%,低血糖占1.6%。高血糖与那些需要机械通气和血管加压药物的病例有统计学意义的关联。高血糖患者预后较差,死亡风险为高血糖患者的5.78倍。结论:当血糖临界值>126 mg/dl、>150 mg/dl、>200 mg/dl时,平均高血糖患病率分别为80.3%、72%、31%。重症高血糖患者的发病率和死亡率均有增加。由于危重症患者的高血糖水平没有明确的临界值,需要更多的研究和共识。
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Glycemic abnormalities and their outcome in critically ill pediatric patients admitted in pediatric intensive care unit of tertiary care hospital
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.
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