Intensive Care Medicine

, Volume 36, Issue 2, pp 312–320 | Cite as

Organ dysfunction is associated with hyperglycemia in critically ill children

  • Ursula G. KyleEmail author
  • Jorge A. Coss Bu
  • Curtis E. Kennedy
  • Larry S. Jefferson



To determine the association between organ dysfunction and hyperglycemia in critically ill children receiving intravenous insulin.


Retrospective chart review (cohort study).


Pediatric intensive care unit in a university hospital.


n = 110 patients; inclusion criteria: ICU hospitalization from May 2005 to May 2006; insulin drip to manage hyperglycemia. Exclusion criteria: insulin drip <48 h; diabetic patients.


Duration of hyperglycemia: sum of hours of hyperglycemia (≥126 mg/dl). Hypoglycemia (blood glucose <40 mg/dl). Organ dysfunction was determined per International Pediatric Sepsis Consensus Conference criteria. Multiple logistic regression models determined the association between ≥3 compared to <3 organ dysfunctions and hyperglycemia, hypoglycemia, and mortality, after adjustment for confounding variables (age, gender, PRISM score, vasopressors, steroids).

Main results

Organ dysfunction ≥3 compared to <3 after adjustment for confounders was associated with intermittent hyperglycemia of ≥24 h (OR 6.1, CI 1.8–21.2; p = 0.004). Hyperglycemia trended towards significance with mortality [3.2 (CI 0.9–11.6, p = 0.079)]. Hypoglycemia, after adjusting for the above, was not associated with mortality.


Organ dysfunction (≥3 versus <3) was significantly associated with hyperglycemia for ≥24 h and hypoglycemia. Hyperglycemia trended toward significance with mortality in critically ill children. There was no association between hypoglycemia and mortality.


Hyperglycemia Intensive insulin therapy Organ dysfunction Hypoglycemia Critically ill Children 


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Copyright information

© Copyright jointly hold by Springer and ESICM 2009

Authors and Affiliations

  • Ursula G. Kyle
    • 1
    Email author
  • Jorge A. Coss Bu
    • 1
  • Curtis E. Kennedy
    • 1
  • Larry S. Jefferson
    • 1
  1. 1.Pediatric Critical Care Medicine, Texas Children’s HospitalBaylor College of MedicineHoustonTexasUSA

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