Control of serum glucose concentration in critical illness

Sarah B. Kandil, Michael Miksa, E. Vincent S Faustino

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose of review: Hyperglycemia is a significant problem for children in the ICU. Use of tight glycemic control (TGC) to manage hyperglycemia remains controversial, especially given the potential risk of insulin-induced hypoglycemia. This review will address the latest evidence regarding TGC in critically ill children. Recent findings: Two randomized controlled trials (RCT) involving primarily postoperative cardiac surgery patients demonstrated the feasibility and safety of TGC in pediatric patients. The trials, however, had discrepant results with regards to the benefit of TGC. There is also uncertainty about the generalizability of these results to nonpostoperative cardiac patients. There is only one published study addressing the long-term safety of TGC in children. In this study, hypoglycemia was not associated with adverse effects on neurocognitive development. In contrast, articles from adult studies demonstrate increased risk of death with hypoglycemia. Summary: Although the clinical benefit of TGC in critically ill children is still unclear, TGC can be done safely in this population.

Original languageEnglish (US)
Pages (from-to)297-303
Number of pages7
JournalCurrent Opinion in Pediatrics
Volume25
Issue number3
DOIs
StatePublished - Jun 2013
Externally publishedYes

Fingerprint

Critical Illness
Hypoglycemia
Glucose
Serum
Hyperglycemia
Safety
Thoracic Surgery
Uncertainty
Randomized Controlled Trials
Insulin
Pediatrics
Population

Keywords

  • Critical illness
  • Hyperglycemia
  • Hypoglycemia
  • Pediatrics
  • Tight glycemic control

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Control of serum glucose concentration in critical illness. / Kandil, Sarah B.; Miksa, Michael; Faustino, E. Vincent S.

In: Current Opinion in Pediatrics, Vol. 25, No. 3, 06.2013, p. 297-303.

Research output: Contribution to journalArticle

Kandil, Sarah B. ; Miksa, Michael ; Faustino, E. Vincent S. / Control of serum glucose concentration in critical illness. In: Current Opinion in Pediatrics. 2013 ; Vol. 25, No. 3. pp. 297-303.
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