Hyperglycemia and use of the insulin in critically ill child [Abstract in English]

Elisa Baldasso, Pedro Celiny Ramos Garcia, Jefferson Pedro Piva, Ricardo Branco

Abstract


Objective: To describe the evidences on mechanisms
of hyperglycemia and insulin resistance in sepsis and septic
shock, its repercussions in morbidity and mortality in
Pediatric Intensive Care Units, as well as results and
security of the use of the insulin.

Methods: Literature review from MEDLINE database
between 1998 and 2005, using the terms insulin, hyperglycemia,
sepsis and septic shock.

Results: Studies in adults report benefits in mortality
and morbidity with strict hyperglycemic control and use of
insulin. Studies involving pediatric patients, in the
majority retrospective, present similar results. The risk of
hypoglycemia does not seem to be significant.

Conclusions: Although the published studies had not
yet brought evidences definitive in pediatric patients,
it seems rational to offer hyperglycemic control and use
of insulin when necessary. Clinical protocols of hyperglycemia
control and use of insulin in these patients are
required.

KEY WORDS: SEPSIS, SHOCK SEPTIC, INSULIN, HYPERGLYCEMIA.



e-ISSN: 1980-6108 | ISSN-L: 1806-5562


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