@Article{duepublico_mods_00077561, author = {Bruns, Nora and Gro{\ss}e Lordemann, Anja and Rasche, Tobias and Meyburg, Jochen and Kr{\"u}ger, Marcus and Wieg, Christian and Gratopp, Alexander and Hoppenz, Marc and Heitmann, Friedhelm and Hoppen, Thomas and L{\"o}ffler, G{\"u}nther and Felderhoff-M{\"u}ser, Ursula and Dohna-Schwake, Christian}, title = {Iatrogenic severe hyperglycemia due to parenteral administration of glucose in children: a case series}, year = {2020}, month = {Dec}, day = {01}, keywords = {Hyperglycemia; Iatrogenic; Pediatric; Treatment error; Parenteral feeding; Parenteral nutrition; Glucose; Administration}, 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{\thinspace}>{\thinspace}300{\thinspace}mg/dl (16.7{\thinspace}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{\thinspace}mg/dl (54.6{\thinspace}mmol/l) (range 594--2240{\thinspace}mg/dl; 33.0--124.3{\thinspace}mmol/l) and median time to normoglycemia was 7{\thinspace}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.}, note = {<p>The publication of this article was supported by the Publication Fund of the University of Duisburg-Essen.</p> <p>The study received funding by the IFORES Program of the Medical Faculty, University Duisburg-Essen and by the Stiftung Universit{\"a}tsmedizin, University Hospital Essen.</p> <p>Open Access funding enabled and organized by Projekt DEAL.</p>}, note = {<p>Bruns, N., Gro{\ss}e Lordemann, A., Rasche, T. <em>et al.</em> Iatrogenic severe hyperglycemia due to parenteral administration of glucose in children -- a case series. <em>Ital J Pediatr</em> <strong> 46</strong>, 179 (2020). <a href="https://doi.org/10.1186/s13052-020-00939-9">https://doi.org/10.1186/s13052-020-00939-9</a></p> <p>Published 01 December 2020</p>}, note = {Version of Record / Verlagsversion}, doi = {10.1186/s13052-020-00939-9}, url = {https://duepublico2.uni-due.de/receive/duepublico_mods_00077561}, url = {https://doi.org/10.1186/s13052-020-00939-9}, file = {:https://duepublico2.uni-due.de/servlets/MCRFileNodeServlet/duepublico_derivate_00077212/Ital_J_Pediatr_2020_46_179.pdf:PDF}, language = {en} }