Hyperglycemia and its association with clinical outcomes for patients in the pediatric intensive care unit after abdominal surgery.

PURPOSE: We investigated the incidence of hyperglycemia of patients in the pediatric intensive care unit (PICU) after receiving abdominal surgery and its association with clinical outcomes.

METHODS: A retrospective review was performed from November 1, 2010 to November 1, 2011 on all PICU admissions after abdominal surgery. Maximum serum glucose concentrations (Gmax) in PICU, PICU length of stay, total hospital length of stay, deep and systemic infection, wound infection and mortality rates were recorded and analyzed.

RESULTS: A total of 193 children met the inclusion criteria of our research. Maximum glucose levels ranged from 55.7 mg/dL to 415.9 mg/dL (median: 132 mg/dL). Hyperglycemia in PICU was prevalent, with 125 (64.8%) patients having Gmax >110 mg/dL during their PICU stay and 35 (18.8%) having Gmax >200 mg/dL. Average PICU length of stay and total hospital length of stay grew as the maximum glucose levels rose among the four plasma glycemic ranges. The highest serum glucose range patient group also had the highest wound infection rates (14.3% and 11.4%).

CONCLUSIONS: Hyperglycemia was prevalent among patients after major abdominal surgery in PICU and was correlated with increased PICU length of stay, total hospital length of stay. Appropriate glycemic control may improve clinical outcomes for this group of patients.