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2014, Number S2

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Rev Med Inst Mex Seguro Soc 2014; 52 (S2)

Hyperglycemia as a risk factor for mortality in critically ill neonates

Márquez-González H, Muñoz-Ramírez MC, Ramírez-García MÁ, Pineda-Frutos MF, Hernández-Ramírez C, Villa-Romero AR, Sepúlveda-Vildósola AC

Language: Spanish
References: 25
Page: 104-109
PDF size: 184.44 Kb.


ABSTRACT

Background: The sick neonate is susceptible to uncontrolled hyperglycemia by several factors. Our objective was to determine the mortalitypredictive role of hyperglycemia in critically ill neonates.
Methods: A cohort study was conducted in neonates admitted during the fi rst hour of life in the intensive care unit. Prenatal and perinatal variables were recorded including ventilatory management, comorbidities, arterial blood gas, blood chemistry and blood count. Serum glucose ≥ 126 mg/dL and ≥ 180 mg/dL was considered consistent with hyperglycemia in neonates born at term and preterm infants, respectively. The children were followed until discharge from the unit. Measures of central tendency and dispersion for quantitative variables and frequencies for qualitative variables were obtained, as well as Kaplan-Meier curves. Association test using the chi-square test for exposed and non-exposed groups and Cox regression analysis was performed and risk calculation was made using the hazard ratio.
Results: Out of 146 patients, 16 died (10.7 %). Most common causes were respiratory distress syndrome, perinatal asphyxia, meconium aspiration and sepsis. Association was found between hyperglycemia and chest compression, metabolic acidemia, hyperlactatemia, mechanical ventilatory support, intraventricular hemorrhage and death.
Conclusions: Hyperglycemia was an independent risk factor for the prediction of death, with a likelihood of death of 56.8 % when it was present.


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