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PhilSPEN Online Journal of Parenteral and Enteral Nutrition

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Submitted Abstracts

PENSA 2017 Congress

Submitted: June 8, 2017

Abstract ID = 24

Title: Association between dysglycemia and mortality in children receiving parenteral nutrition in pediatric intensive care unit

Author(s): Khajavi L.1, Khademi GH.2, Mehramiz M.1, Norouzy A.1, Safarian M.1, Mehdizadeh A.1

Institution where study was conducted:

  1. Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  2. Department of Pediatrics, Dr. Sheikh Pediatric Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

University of Medical Sciences, Mashhad, Iran

Keywords:

Background: One of the most important complications of parenteral nutrition is hyperglycemia.

Objectives: The aim of this study was to assess the effect of parenteral nutrition dysglycemia on clinical outcomes among critically ill children in pediatric intensive care unit (PICU).

Methods: Charts of 201 critically ill children admitted to PICU of Dr. Sheikh pediatric hospital, during 2012-2015 were reviewed retrospectively. Patients who were below age of six and had received at least 60% of total energy from parenteral nutrition (PN) for a minimum of five days in PICU, were included. The exclusion criteria were diagnosis of diabetes mellitus, primary hypoglycemia, inborn metabolic disorders and dialyses. Blood sugar (BS)≥150 mg/dl was defined as hyperglycemia and BS≤60 mg/dl as hypoglycemia. Based on blood glucose, patients were divided into four groups: 1) "Only hyperglycemia": having at least one hyperglycemia episode. 2) "Only hypoglycemia group": having at least one hypoglycemia episode. 3) "Glucose variability": having both hypoglycemia and hyperglycemia episodes. 4) "Normoglycemia": all glucose measurements were in normal range.

Results: Hyperglycemia and hypoglycemia occurred in 52.8% and 24.9% of all children, respectively. Glucose variability occurred in 13.9% of all children. Multiple logistic regression analysis showed that glucose variability (OR=3.1; 95% CV, 1.13-8.43) and hyperglycemia (OR=2.14; 95% CV, l.1-4.57) were associated with mortality independently. In "only hypoglycemia" group (n=22) there were only three deaths. There were no significant differences in the quantities of macronutrients prescribed via PN among the four groups.

Conclusion: Hyperglycemia and glucose variability are strong predictors of mortality in pediatrics receiving parenteral nutrition.

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