Hyperglycemia and its association with clinical outcomes in postsurgical neonates and small infants in the intensive care unit

PurposeThe aim of the research was to investigate the association between postsurgical hyperglycemia of neonates and small infants (< 6 months) during their stays in intensive care unit and clinical outcomes.MethodsA retrospective study of 180 patients including neonates and small infants (< 6 months) admitted to pediatric intensive care unit (PICU) after major abdominal and thoracic surgeries from July 2012 to December 2014 was performed. Clinical data including serum glucose levels, surgical procedures, PICU length of stays, total length of hospital stays, systemic infections and wound infections were recorded and analyzed. Surgical diagnosis and Pediatric Risk of Mortality III (PRISM III) score were analyzed as confounding factors.ResultsMaximum glucose values (Gmax) ranged from 4.8 to 32.9 mmol/L (median level: 8.4 mmol/L). Hyperglycemia was prevalent among this group of patients. 93.3% of them experienced hyperglycemia (> 6.1 mmol/L) and 20% had severe hyperglycemia (> 11.0 mmol/L). Both PICU length of stays and total hospital length of stays increased as Gmax increased (P < 0.001). This trend was still statistically significant when either surgical diagnosis or PRISM score had been controlled as confounding factors. Death rates and infectious rates were not significantly different among four groups of patients with different Gmax.ConclusionsHyperglycemia was prevalent in postsurgical neonates and small infants in PICU and was associated with increased PICU and hospital stays.