PT Unknown
AU Bruns, N
   Große Lordemann, A
   Rasche, T
   Meyburg, J
   Krüger, M
   Wieg, C
   Gratopp, A
   Hoppenz, M
   Heitmann, F
   Hoppen, T
   Löffler, G
   Felderhoff-Müser, U
   Dohna-Schwake, C
TI Iatrogenic severe hyperglycemia due to parenteral administration of glucose in children: a case series
PD 12
PY 2020
DI 10.1186/s13052-020-00939-9
LA en
DE Hyperglycemia; Iatrogenic; Pediatric; Treatment error; Parenteral feeding; Parenteral nutrition; Glucose; Administration
AB 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.
ER