Blood glucose and outcomes in critically ill children in Brazilian Amazon: an observational study

• Autor(a) principal: Farias, Emmerson Carlos Franco de
• Data de Publicação: 2021
• Outros Autores: Carvalho, Patrícia Barbosa de, Pavão Júnior, Manoel Jaime Castro, Dias, Luana Guimarães, Alves, Marília Cunha Botelho, Alves, Samuel Filipe Lopes, Silva, Emanuele Rocha da, Dias, Brenda Tuany Pacheco, Reis, Jéssica Haline Souza dos, Cunha, Katiane da Costa, Chermont, Aurimery Gomes
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Research, Society and Development
• Texto Completo: https://rsdjournal.org/index.php/rsd/article/view/12813
• topic: Glicemia; Mortalidade; Fatores de risco; Unidades de terapia intensiva pediátrica; Hipoglicemia; Hiperglicemia.; Glucosa; Mortalidad; Factores de riesgo; Unidades de cuidados intensivos pediátricos; Hipoglucemia; Hiperglucemia.; Blood Glucose; Mortality; Risk factors; Hypoglycemia; Intensive care units, Pediatric; Hyperglycemia.

Objectives: To determine blood glucose distribution values; to assess the association of admission serum glucose levels with 28-day mortality to the frequency of invasive mechanical ventilation-free days. Design: Retrospective cohort studySetting: Brazilian Amazon Region. Patients: Population (n = 400) composed of patients admitted to the pediatric intensive care unit, from January 2016 to December 2017. Exclusion criteria were patients with length of stay of <24 hours; diabetes mellitus; suspicion or evidence of inborn errors of metabolism; insulin use; palliative care and brain death. Main outcome measures: The patients were divided into 4 groups: 1) serum glucose <60mg/dL; 2) control group if serum glucose between 60-126 mg/dL; 3) between 127-150mg/dL; or 4) if > 150mg/dL. Results: Serum glucose levels frequency were: <60: 43 (11%); 60-126: 235 (58.7%); 127-150: 51 (13%) and > 150: 71 (18%). Groups 3 and 4 had the highest frequency of external origin, with respectively 24 (47.1%) and 40 (56.3%); the main diagnosis was infection, with 26 (51%) and 50 (70.4%), respectively. Sepsis occurred in 24 (47.1%) and 47 (66.2%) individuals in the groups 3 and 4, respectively, while septic shock was more frequent in the group 4 (46 [4.8%]). Group 2 had predominance of ventilator-associated pneumonia with 11 (36.7%). The estimate of ventilation-free days in group 4 was 2.84 (SD +/- 0.69; 95% CI: 1.5-4.2). Conclusion: Hyperglycemia group had a lower frequency of ventilation-free days and higher 28-day mortality.