Hyperglycemia in pediatric head trauma patients: a cross-sectional study

Abstract

-Objective: To verify the prevalence of acute hyperglycemia in children with head trauma stratified by the Glasgow coma scale (GCS). Method: A prospective cross-sectional study carried out with information from medical records of pediatric patients presenting with head injury in the emergency room of a referral emergency hospital during a one year period. We considered the cut-off value of 150 mg/dL to define hyperglycemia. Results: A total of 340 children were included and 60 (17.6%) had admission hyperglycemia. Hyperglycemia was present in 9% of mild head trauma cases; 30.4% of those with moderate head trauma and 49% of severe head trauma. We observed that among children with higher blood glucose levels, 85% had abnormal findings on cranial computed tomography scans. Conclusion: Hyperglycemia was more prevalent in patients with severe head trauma (GCS ≤8), regardless if they had or not multiple traumas and in children with abnormal findings on head computed tomography scans.Key WordS: adolescents, children, head trauma, hyperglycemia, prevalence. Hiperglicemia em pacientes pediátricos com traumatismo craniencefálico: estudo de corte transversalResumo -Objetivo: Verificar a prevalência de hiperglicemia aguda em crianças vítimas de trauma craniencefálico, de acordo com a escala de coma de Glasgow (GCS). Método: estudo prospectivo, de corte transversal realizado por meio do acompanhamento de prontuários médicos de pacientes na faixa etária pediátrica admitidos na unidade de urgência de um hospital de referência vítimas de traumatismo craniencefálico, durante um ano. Consideramos o valor de corte em 150 mg/dL para definição de hiperglicemia. Resultados: 340 crianças foram incluídas no estudo e 60 (17,6%) apresentaram hiperglicemia na admissão. Hiperglicemia esteve presente em 9% dos casos de trauma craniano leve, 30,4% daqueles com trauma craniano moderado e em 49% dos pacientes com trauma craniano grave. Verificamos que, entre as crianças com níveis elevados de glicemia, 85% apresentavam alterações radiológicas verificadas na tomografia computadorizada do crânio. Conclusão: A hiperglicemia foi mais prevalente em pacientes com traumatismo craniano grave (GCS ≤8), assim como naqueles com alterações identificadas na tomografia computadorizada do crânio, independente da presença de politraumatismo.

Traumatic brain injury: clinical and pathological parameters in an experimental weightdrop model

“…Mortality was greater in the groups where glycemia had great deflections or remained elevated in relation to the pre-traumatic levels agreeing with previous studies about the theme 18 . There are still few clarifications about the real influence of hyperglycemia in the progression of the cerebral damage related to the trauma, although it is admissible a reserved prognosis to hyperglycemic patients after cranial traumas 18 .…”

Cerebral traumatic injury and glucose metabolism: a scoping review

“…Effective glucose control measures can include insulin therapy, glucose monitoring, and the implementation of protocols for glycemic management in critical care settings. By optimizing glucose levels and minimizing the duration of exposure to hyperglycemia, clinicians can help to improve the functional outcomes and overall prognosis of pediatric TBI patients [19][20][21][22]. Hyperglycemia following traumatic brain injury (TBI) is common in both children and adults and has been associated with adverse outcomes in both groups.…”