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- Title
Iatrogenic severe hyperglycemia due to parenteral administration of glucose in children – a case series.
- Authors
Bruns, Nora; Große Lordemann, Anja; Rasche, Tobias; Meyburg, Jochen; Krüger, Marcus; Wieg, Christian; Gratopp, Alexander; Hoppenz, Marc; Heitmann, Friedhelm; Hoppen, Thomas; Löffler, Günther; Felderhoff-Müser, Ursula; Dohna-Schwake, Christian
- Abstract
Background: Iatrogenic severe hyperglycemia (ISH) caused by glucose-containing i.v. solution is a potentially fatal treatment error. The objective of this study was to investigate the causes, circumstances, course of disease, and complications of ISH > 300 mg/dl (16.7 mmol/l) in neonates and children. Methods: We emailed a survey to 105 neonatal and pediatric intensive care units in Germany, Austria, and Switzerland, asking to retrospectively report cases of ISH. Results: We received 11 reports about premature infants to children. Four patients (36%) had poor outcome: 2 died and 2 suffered persistent sequelae. The highest observed blood glucose was at median 983 mg/dl (54.6 mmol/l) (range 594–2240 mg/dl; 33.0–124.3 mmol/l) and median time to normoglycemia was 7 h (range 2–23). Blood glucose was higher and time to normoglycemia longer in patients with poor outcome. Invasive therapy was required in 73% (mechanical ventilation) and 50% (vasopressor therapy) of patients, respectively. Administration of insulin did not differ between outcome groups. Patients with poor outcome showed coma (100% vs. 40%) and seizures (75% vs. 29%) more frequently than those with good outcome. Conclusions: ISH is a severe condition with high morbidity and mortality. Further research to amplify the understanding of this condition is needed, but focus should largely be held on its prevention.
- Subjects
AUSTRIA; GERMANY; SWITZERLAND; GLUCOSE; HYPERGLYCEMIA; IATROGENIC diseases; MEDICAL errors; NEONATAL intensive care; PARENTERAL feeding; NEONATAL intensive care units; TREATMENT effectiveness; SEVERITY of illness index; DESCRIPTIVE statistics; PARENTERAL infusions; CHILDREN
- Publication
Italian Journal of Pediatrics, 2020, Vol 46, Issue 1, pN.PAG
- ISSN
1720-8424
- Publication type
Article
- DOI
10.1186/s13052-020-00939-9