tailieunhanh - Báo cáo y học: "Pathophysiological aspects of hyperglycemia in children with meningococcal sepsis and septic shock: a prospective, observational cohort study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Pathophysiological aspects of hyperglycemia in children with meningococcal sepsis and septic shock: a prospective, observational cohort study. | Verhoeven et al. Critical Care 2011 15 R44 http content 15 1 R44 KS CRITICAL CARE RESEARCH Open Access Pathophysiological aspects of hyperglycemia in children with meningococcal sepsis and septic shock a prospective observational cohort study 1 2 31 1 Jennifer J Verhoeven Marieke den Brinker Anita CS Hokken-Koelega Jan A Hazelzet Koen FM Joosten Abstract Introduction The objective of this study was to investigate the occurrence of hyperglycemia and insulin response in critically ill children with meningococcal disease in the intensive care unit of an academic children s hospital. Methods Seventy-eight children with meningococcal disease were included. The group was classified into shock non-survivors shock survivors and sepsis survivors. There were no sepsis-only non-survivors. The course of laboratory parameters during 48 hours was assessed. Insulin sensitivity and p-cell function on admission were investigated by relating blood glucose level to insulin level and C-peptide level and by homeostasis model assessment HOMA p-cell function HOMA- B and insulin sensitivity HOMA- S . Results On admission hyperglycemia glucose mmol l was present in 33 of the children. Shock and sepsis survivors had higher blood glucose levels compared with shock non-survivors. Blood glucose level on admission correlated positively with plasma insulin C-peptide cortisol age and glucose intake. Multiple regression analysis revealed that both age and plasma insulin on admission were significantly related to blood glucose. On admission 62 of the hyperglycemic children had overt insulin resistance glucose mmol l and HOMA- S 50 17 had p-cell dysfunction glucose mmol l and HOMA- B 50 and 21 had both insulin resistance and p-cell dysfunction. Hyperglycemia was present in 11 and 8 of the children at 24 and 48 hours after admission respectively. Conclusions Children with meningococcal disease often show hyperglycemia on admission. Both insulin resistance and p-cell .