מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Severely burned children who are hyperglycemic have a higher mortality rate, reduced skin graft take and more infection compared with patients with good glucose control, according to a report in the September issue of The Journal of Trauma.
Dr. Dennis C. Gore from the University of Texas Medical Branch, in Galveston, and colleagues reviewed the medical records of 58 pediatric patients who had burns on 60% or more of their body surface. Thirty-three patients were classified as having poor glucose control because at least 40% of all plasma glucose measurements were 7.8 mmol/L (140 mg/dL) or more.
After adjustment for length of hospital stay, patients with poor glucose control had a significantly greater incidence of positive blood cultures for bacteremia and fungemia, particularly yeast, compared with patients with adequate glucose control (p < 0.05), the researchers found.
Dr. Gore's group reports that there were more skin graft procedures and fewer skin graft takes (64%) among hyperglycemic patients compared with normoglycemic patients (percent take per operative procedure 64% and 88%, respectively, p < 0.05). Nine of the hyperglycemic patients died compared with one of the normoglycemic patients (p < 0.05).
"Although it is unknown whether more aggressive regimens to normalize glucose values may be warranted in critically injured patients, the association between persistent hyperglycemia and subsequent mortality in severely burned patients is evident, and a more intense focus on minimizing hyperglycemia in critically ill patients deserves strong consideration," Dr. Gore and colleagues conclude.
J Trauma 2001;51:540-544.
-Westport Newsroom 203 319 2700
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