Main Article Content
poor clinical outcomes and high mortality rate in critically ill
patients. Glucose toxicity results in cell damage that leads to
Objective To evaluate for an association between hyperglycemia
and the incidence of organ dysfunction in shock patients.
Methods This cross-sectional study was conducted in the
pediatric intensive care unit (PICU) of Dr. Moh. Hoesin
Hospital, Palembang from June to November 2011. Subjects
were consecutively-enrolled, shock patients without a history
of diabetes mellitus. Illness severity and organ dysfunction were
determined by pediatric risk of mortality (PRISM) III score and
pediatric logistic organ dysfunction (PELOD) scores, respectively.
Hyperglycemia was defined as a blood glucose level 2: 110 mg/dL.
Statistical analysis was performed with SPSS version 15.
Results Mean age of subjects was 2.30 (SD 2.93) years. Mean
PRISM III score was 15 .11 (SD 5 .63). Prevalence of hyperglycemia
was 80.0%. Mean glucose level was 179.51 (SD 86.84) mgldL.
Mean PELOD score was 16.02 (SD 13.87). Organ dysfunction was
observed in 86.7% of subjects. The most common organ dysfunction
observed in our subjects was liver dysfunction (73.3%). There
was a significant association between hyperglycemia and organ
dysfunction (OR43.750;95%CI 4.036 to474.252, P=0.001). The
blood glucose level cutoff points indicative of organ dysfunction,
PRISM III score 2: 8, and PELOD score 2: 20.5 were 114.5 mg/
dL, 129 mgldL, and 166 mg/dL, respectively.
Conclusion There is an association between hyperglycemia and
organ dysfunction. The upper limit blood glucose level indicative of
organ dysfunction is 114.5 mg/dL. A glucose level of 129 mgldL may
be considered to be a warning to start blood glucose monitoring. A
level above 166 mgldL may be used to indicate the necessity of starting
insulin therapy intervention.
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