Glycemic level in mechanically ventilated children with bronchiolitis*

Branco, Ricardo Garcia; Tasker, Robert C.

doi:10.1097/01.pcc.0000288712.67749.45

Cited by 38 publications

(35 citation statements)

References 19 publications

(27 reference statements)

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“…Hyperglycemia is frequent in children with bronchiolitis requiring mechanical ventilation. Patients with higher sustained blood glucose level were more likely to require high-frequency oscillatory ventilation and higher peak flow[28]. In our study, hyperglycemia was not frequent in patients with bronchiolitis or those with bacterial co-infection.…”

Section: Discussionmentioning

confidence: 53%

The use of C-reactive protein in predicting bacterial co-Infection in children with bronchiolitis

et al. 2011

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Background:Bronchiolitis is a potentially life-threatening respiratory illness commonly affecting children who are less than two years of age. Patients with viral lower respiratory tract infection are at risk for co-bacterial infection.Aim:The aim of our study was to evaluate the use of C-reactive protein (CRP) in predicting bacterial co-infection in patients hospitalized for bronchiolitis and to correlate the results with the use of antibiotics.Patients and Methods:This is a prospective study that included patients diagnosed with bronchiolitis admitted to Makassed General Hospital in Beirut from October 2008 to April 2009. A tracheal aspirate culture was taken from all patients with bronchiolitis on admission to the hospital. Blood was drawn to test C-reactive protein level, white cell count, transaminases level, and blood sugar level.Results:Forty-nine patients were enrolled in the study and were divided into two groups. Group 1 included patients with positive tracheal aspirate culture and Group 2 included those with negative culture. All patients with a CRP level ≥2 mg/dL have had bacterial co-infection. White cell count, transaminases and blood sugar levels were not predictive for bacterial co-infection. The presence of bacterial co-infection increased the length of hospital stay in the first group by 2 days compared to those in the second group.Conclusion:Bacterial co-infection is frequent in infants with moderate to severe bronchiolitis and requires admission. Our data showed that a CRP level greater than 1.1 mg/dL raised suspicion for bacterial co-infection. Thus, a tracheal aspirate should be investigated microbiologically in all hospitalized patients in order to avoid unnecessary antimicrobial therapy and to shorten the duration of the hospital stay.

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Section: Discussionmentioning

confidence: 53%

The use of C-reactive protein in predicting bacterial co-Infection in children with bronchiolitis

et al. 2011

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“…Some authors in the past have defined hyperglycemia as blood glucose level above 150 mg/dl or above 200 mg/dl and found incidence ranging from 16.7% to 56%. [232425] We defined hyperglycemia as blood glucose level above above 126 mg/dl or (>7 mmol/l) as similar level considered in previous studies[926] and as per revised definition for diagnosis of diabetes (fasting blood glucose level >126 mg/dl) in children by WHO[22] Ninety six (95%) out of 101 acutely ill children were in the fasting state for >12 hours and remaining 5 (5%) were in fasting state for >10 hrs. Higher incidence of hyperglycemia in our study was comparable with studies like Srinivasan et al .,[9] Wintergerst et al .,[10] Allen et al .,[27] and Yung et al .…”

Section: Discussionmentioning

confidence: 99%

Hyperglycemia in critically ill children

Patki¹,

Chougule²

2014

Indian Journal of Critical Care Medicine

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Objectives:To determine the incidence and study association of hyperglycemia with outcome of critically ill children.Setting and Design:This was a prospective observational study conducted in eight bedded pediatric intensive care unit (PICU) of a tertiary care hospital.Materials and Methods:One hundred and one critically ill non-diabetic children between ages of 1 month to 16 years were studied from the day of admission till discharge or death. Serial blood sugars were determined first at admission, thereafter every 12 hourly in all children. Blood glucose level above 126 mg/dl (>7 mmol/dl) was considered as hyperglycemia. Children with hyperglycemia were followed 6 hourly till blood glucose fell below 126 mg/dl. Hyper and non-hyperglycemic children were compared with respect to length of stay, mechanical ventilation, use of inotrops and final outcome. Survivors and non-survivors were compared in relation to admission blood glucose, peak blood glucose level and duration of hyperglycemia.Results:Seventy (69.3%) children had hyperglycemia. Requirement of ventilation [(23) 32.9% vs.(3) 9.7%], requirement of inotropic support [(27) 38.6% vs.(5) 16.1%], Mean length of stay in PICU (7.91 ± 5.01 vs. 5.58 ± 1.95 days) and mortality (28.6% vs. 3.2%) among hyperglycemic children was significantly higher (P < 0.05) than that of non-hyperglycemic. Logistic regression analysis showed Peak blood glucose level and duration of hyperglycemia has independent association with increased risk of death.Conclusion:Incidence of hyperglycemia is high in critically ill children and it is associated with high morbidity and mortality.

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“…[18][19][20] Peneliti lain menggunakan nilai cut-off yang berbeda, antara lain 126 mg/dL, 150 mg/dL, dan 200 mg/dL. 7,11,13,21,22 Prevalens subjek yang mengalami hiperglikemia (kadar glukosa >140 mg/dL) pada penelitian kami adalah 28,7%. Temuan tersebut hampir sama dengan penelitian lain yang menggunakan nilai ambang batas sama, yaitu penelitian Allen dkk.…”

Section: Pembahasanunclassified

“…30 Skor PELOD hanya dilakukan satu kali yaitu saat masuk PICU. Leteurtre dkk 30 membagi skor PELOD yang dilakukan pada hari pertama menjadi 3 kelompok, yaitu rendah (< 10), sedang (10)(11)(12)(13)(14)(15)(16)(17)(18)(19), dan tinggi (>20), dengan nilai cut-off 10 dan 20 berhubungan dengan peningkatan mortalitas. Kami juga menggunakan nilai cut-off skor PELOD 20 dan didapatkan 10 subjek yang memiliki nilai PELOD >20.…”

Section: Hubungan Antara Hiperglikemia Dan Luaranunclassified

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Faktor yang Berhubungan dengan Hiperglikemia dan Luarannya pada Anak Sakit Kritis

Rosary

Amalia

Firmansyah

et al. 2016

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Latar belakang. Hiperglikemia pada sakit kritis berhubungan dengan luaran yang lebih buruk, seperti lama penggunaan ventilasi mekanik, dan obat vasoaktif lebih panjang, serta derajat disfungsi organ yang lebih berat. Tujuan. Mengetahui hubungan karakteristik subjek dengan hiperglikemia serta mengetahui perbedaan proporsi subjek yang mengalami hiperglikemia antara kelompok subjek yang memakai ventilasi mekanik, mendapat obat vasoaktif, serta dengan disfungsi organ berat, dibandingkan dengan kelompok subjek yang tidak. Metode. Studi analitik potong lintang dilakukan pada anak sakit kritis di Pediatric Intensive Care Unit (PICU) Rumah Sakit Cipto Mangunkusumo (RSCM) usia 1 bulan-18 tahun, dilakukan antara Maret-Juni 2011. Hasil. Didapatkan 87 subjek penelitian, 60 di antaranya laki-laki. Hiperglikemia ditemukan pada 25/87 (28,7%) subjek dengan median kadar glukosa darah 121 (37-443) mg/dL Hiperglikemia ditemukan lebih banyak pada laki-laki, usia >1-5 tahun, gizi kurang, dan pasca-bedah, tetapi tidak ditemukan hubungan yang bermakna. Subjek yang menggunakan ventilasi mekanik dan vasoaktif memiliki proporsi lebih besar mengalami hiperglikemia dibandingkan dengan subjek yang tidak, tetapi perbedaan ini juga tidak bermakna. Enam dari 10 subjek yang memiliki skor Pediatric Logistic Organ Dysfunction (PELOD) tinggi mengalami hiperglikemia. Proporsi ini lebih besar dibandingkan subjek dengan skor PELOD rendah, yaitu 19/77 subjek (p=0,03). Kesimpulan. Proporsi subjek yang mengalami hiperglikemia lebih besar pada anak dengan disfungsi organ berat daripada disfungsi organ ringan. Karakteristik subjek tidak berhubungan dengan hiperglikemia pada sakit kritis. Tidak terbukti adanya perbedaan proporsi subjek yang mengalami hiperglikemia pada anak sakit kritis yang menggunakan ventilasi mekanik dan obat vasoaktif dibandingkan dengan kelompok subjek yang tidak. Sari Pediatri 2013;15(1):32-8.

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Glycemic level in mechanically ventilated children with bronchiolitis*

Cited by 38 publications

References 19 publications

The use of C-reactive protein in predicting bacterial co-Infection in children with bronchiolitis

The use of C-reactive protein in predicting bacterial co-Infection in children with bronchiolitis

Hyperglycemia in critically ill children

Faktor yang Berhubungan dengan Hiperglikemia dan Luarannya pada Anak Sakit Kritis

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