Glucose control in severely thermally injured pediatric patients: What glucose range should be target?
Annals of Surgery
Year, Volume, Issue, Page(s):
2010, vol. 252, issue 3, pp 521-528
Study determined which glucose levels are associated with improved morbidity and mortality in thermally injured children. Two-hundred eight pediatric patients with burns over 30 percent of their total body surface area were included in this trial. Several statistical models were used to determine the daily average and 6 AM glucose targets that were associated with improved morbidity and mortality. Patients were then divided into good- and poor-glucose-controlled patients and demographics, clinical outcomes, infection, sepsis, inflammatory, and hypermetabolic responses were determined. Statistical modeling showed that hyperglycemia is a strong predictor of adverse hospital outcome and that daily 6 AM glucose level of 130 milligrams per deciliter (mg/dL) and daily average glucose levels of 140 mg/dL are associated with improved morbidity and mortality postburn. When comparing good- and poor-glucose-control groups, it was determined that patients with glucose levels of 130 mg/dL exert attenuated hypermetabolic and inflammatory responses, as well as significantly lower incidence of infections, sepsis, and mortality compared with patients with poor glucose control. These findings suggest that a blood glucose level of 130 mg/dL should be targeted in severely burned patients.
Jeschke M.G.; Kraft R.; Emdad F.; Kulp G.A.; Williams F.N.; Herndon, D.N.
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