Skip to main content

Decreased intravenous glucose intake safely prevents hyperglycemia in postsurgical children

Introduction

Critical illness induced hyperglycemia in critically ill children can be treated with intensive insulin therapy, but hypoglycaemia is a potential serious side effect. We have investigated whether decreasing intravenous glucose intake, as an alternative method, improves plasma glucose levels without affecting glucose production and protein balance in postsurgical children.

Methods

Eight children (age 9.8 ± 1.9 months, weight 9.5 ± 1.1 kg) admitted to the pediatric ICU after surgical correction for nonsyndromal craniosynostosis were studied in a randomized blinded cross-over setting to receive standard glucose (SG, 5.0 mg/kg/minute) or low glucose (LG, 2.5 mg/kg/minute). A 10-hour stable isotope tracer protocol was conducted 6 hours after surgery to study glucose and protein metabolism.

Results

During SG, hyperglycemia (>110 mg/dl) was present, while LG resulted in normoglycemia (LG 105 ± 10 vs. SG 133 ± 30 mg/dl; P = 0.02), but not in hypoglycemia. Endogenous glucose production increased during LG (LG 2.6 ± 1.5 vs. SG 1.1 ± 1.4 mg/kg/minute; P = 0.05). Whole body protein balance was slightly negative in both groups and was not affected by glucose intake.

Conclusions

Standard glucose intake in postsurgical children induced hyperglycemia. Decreasing the intake by one-half of current standards resulted in normoglycemic levels, with increased endogenous glucose production. Patients were in a slight catabolic state and decreasing glucose intake did not deteriorate this. Decreasing glucose intake is a safe method to prevent hyperglycemia in critically ill postsurgical children.

Author information

Affiliations

Authors

Corresponding author

Correspondence to CT De Betue.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

De Betue, C., Verbruggen, S., Schierbeek, H. et al. Decreased intravenous glucose intake safely prevents hyperglycemia in postsurgical children. Crit Care 15, P400 (2011). https://doi.org/10.1186/cc9820

Download citation

Keywords

  • Hyperglycemia
  • Hypoglycemia
  • Glucose Intake
  • Intensive Insulin Therapy
  • Craniosynostosis