Researchers suggest a potential link between hyperglycemia and poor outcome in children with severe traumatic brain injuries (TBIs). The recent study was designed to determine the relationship between hyperglycemia and patient outcome in infants and children with severe TBIs.
The study reportedly encompassed a retrospective review of children admitted after severe TBI during the years 1999 to 2004. According to the study, 57 pediatric patients received standard TBI treatment protocol. Researchers add that exogenous glucose was withheld from the patients for 48 hours following injury unless hypoglycemia was observed. The time periods reportedly analyzed during the study were the first 48 hours following injury, and the later 49 hours to 168 hours. Once these hours were defined, researchers report, mean blood glucose concentrations were calculated. The study also reports that study participants were categorized based upon peak blood glucose concentrations during each time period.
During the later 49 hours to 168 hours, researchers report observing a link between elevated mean serum glucose concentration and outcome. The study’s results indicate that the link remained significant following correction for injury severity, age, and exposure to insulin. The results add that during these later hours, children within the designated severe hyperglycemia group exhibited a greater decrease in positive outcome compared to children within the other glycemic groups. Researchers say, however, that when adjustments were made for exposure to insulin, the association was no longer statistically significant.
Researchers conclude that the study’s results suggest a relationship between the onset of hyperglycemia in pediatric TBI patients beyond the initial 48 hours following injury and poorer outcome. The results indicate the relationship was present in the analysis of mean blood glucose concentrations and in patients who exhibited episodic severe hyperglycemia.
Researchers recommend further, prospective studies in order to pinpoint whether the manipulation of serum glucose concentration can improve pediatric patient outcome following TBI.
The study appears in the journal, Pediatric Critical Care Medicine.
Source: Pediatric Critical Care Medicine