European Journal of Molecular & Clinical Medicine

Abstract

Background: Stress induced hyperglycaemia and its effects are a fairly common cause of concern in recent times, in the ICU settings with it being linked directly to mortality and morbidity. In this prospective observational study, we tried to find the salient demographic profile in stress induced hyperglycaemia, if any. Clinical outcome and its correlation to the type of diagnosis has also studied.
Objective:To evaluate the association of hyperglycaemia with clinical outcome of critically ill children. To assess the variation in incidence of hyperglycaemia with different diagnoses of children admitted in PICU.
Material and Methods: This was a prospective observational study done in Pediatric Intensive Care Unit of a government run tertiary level hospital on 400 children in the age group between 2months to 15 years with a PEWS of 5 or more at the time of admission, over a period of one-year period between April 2018 to May 2019.
Results: Hyperglycemia was observed in 31% of study population(n=124). Hyperglycaemia was mostly observed in CNS disease (n=78, 62.9%) followed by renal disease (n=36, 29%). Most of the hyperglycemic patients had (n=56, 45.16%) BMI <-3SD.  There was statistically significant association found between Glucose Level, Nutritional Status and mortality (P=0.001). Many hyperglycemic patients (n=37, 29.8%) required mechanical ventilation(p=0.001). Ionotropic support given to 49(39.5%) hyperglycemic patients (P=0.001). Among total 28 deaths, 19 (67.8%) patients had persistent hyperglycaemia, 7(25%) had impaired glycaemic level. Statistically significant difference found in Mortality Rate according to glycaemic level(P=0.001).
Conclusion: Hperglycemia is a common finding in PICU which was more frequently observed in those children who needed mechanical ventilation and ionotropes. It may be associated with poorer outcome in term of mortality and longer PICU LOS.