Hyperglycemia and use of the insulin in critically ill child <b>[Abstract in English]</b>

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.