Tight Glycemic Control Is Not Beneficial — And May Be Harmful — In Critically Ill Children

A randomized trial found that maintaining blood glucose between 80–100 mg/dL, compared with 150–180 mg/dL, did not result in fewer intensive care unit days or lower mortality.

Whether tight glycemic control benefits critically ill children in the intensive care unit (ICU) is unclear. To address this issue, researchers randomized 713 children (ages 1.4–12.8 years) with hyperglycemia (blood glucose >130 mg/dL) admitted to 32 ICUs to a target blood glucose level of 80 to 100 mg/dL or 150 to 180 mg/dL. Children with diabetes or cardiac surgery were excluded. The study protocol included continuous glucose monitoring and a computerized algorithm for insulin adjustment.

Insulin was administered to 98.6% of patients in the lower-target group and 61.6% in the higher-target group. The median number of ICU-free days to day 28 (the primary outcome measure) did not differ significantly between the two groups in either a per-pr…

Reviewing Author

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

Tight Glycemic Control Is Not Beneficial — And May Be Harmful — In Critically Ill Children

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Reviewing Author