Pediatric anesthesia & critical care
The association of hypoglycemia with outcome of critically ill children in relation to nutritional and blood glucose control strategies
Authors' conclusion
Critically ill children exposed to hypoglycemia in PICU were at higher risk of impaired executive functions after 4 years, especially in cases of spontaneous/recurrent hypoglycemia.
Study context
- Population
- Critically ill children in the PEPaNIC RCT (early vs withheld parenteral nutrition (PN))674 with 4-year follow-up
- Participants
- 1,440 children
- Comparison
- Hypoglycemia vs no hypoglycemia in PICU
- Primary endpoint
- Mortality and neurodevelopmental outcome
- Follow-up
- 4 years
Methodological detailsmulticentre, multivariable regression, Models adjusted for baseline serum NSE and S100B in patients with blood samples (N = 556)
- Multicentre
- Multivariable regression
- Models adjusted for baseline serum NSE and S100B in patients with blood samples (N = 556)
Primary result
As reported in the abstract
Mortality and 4-year neurodevelopmental outcome
- Hypoglycemia univariably associated with higher mortality in PICU, at 90 days and 4 years, but not after adjustment for risk factors
- At 4 years, children with hypoglycemia scored significantly worse for certain parent/caregiver-reported executive functions (working memory, planning and organization, metacognition), also after adjustment incl. baseline NSE and S100B
Further findings
Interaction with randomized nutritional strategy or treatment center
- Potential interaction: tight glucose control and withholding early PN may be protective
Iatrogenic vs spontaneous/recurrent hypoglycemia (sensitivity analysis)
- Impaired executive functions most pronounced with spontaneous or recurrent hypoglycemia
Original publication
The association of hypoglycemia with outcome of critically ill children in relation to nutritional and blood glucose control strategies. Crit Care. Published 26 June 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →