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Risk Factors for Critical Illness Hyperglycemia (CIH) in Pediatric Patients

Purpose: To identify a pediatric patient in the ICU who is at increased risk for developing critical illness hyperglycemia (CIH).

Description

Preissig and Rigby identified children in the ICU who are more likely to develop critical illness hyperglycemia (CIH). These patients may benefit from attempts to achieve better glucose control. The patients are from Emory University and the Children's Healthcare of Atlanta.


 

Patient selection: >= 6 months old, >= 5 kilograms without severe liver disease or Type 1 diabetes mellitus

 

Criteria for CIH: whole blood glucose > 140 mg/dL on 2 consecutive samples drawn 1-2 hours apart

 

Conditions associated with CIH in pediatric patients:

(1) following neurosurgery

(2) sepsis

(3) mechanical ventilation

(4) vasopressors

(5) extracorporeal support

(6) high illness severity score

 

In evaluating a patient with apparent hyperglycemia it is important to detect contamination when drawing a blood sample from a line infusing a glucose solution (pseudohyperglycemia).

 

Aggressive attempts to control hyperglycemia can result in hypoglycemia, which can cause morbidity if severe and prolonged.

 


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Specialty

Objective

ICD-10