[Hyperglycemia as a risk factor for mortality in critically ill neonates].

BACKGROUND

The sick neonate is susceptible to uncontrolled hyperglycemia by several factors. Our objective was to determine the mortality-predictive role of hyperglycemia in critically ill neonates.

METHODS

A cohort study was conducted in neonates admitted during the first hour of life in the intensive care unit. Prenatal and perinatal variables were recorded including ventilatory management, comorbidities, arterial blood gas, blood chemistry and blood count. Serum glucose greater than or equal to 126 mg/dL and greater than or equal to 180 mg/dL was considered consistent with hyperglycemia in neonates born at term and preterm infants, respectively. The children were followed until discharge from the unit. Measures of central tendency and dispersion for quantitative variables and frequencies for qualitative variables were obtained, as well as Kaplan-Meier curves. Association test using the chi-square test for exposed and non-exposed groups and Cox regression analysis was performed and risk calculation was made using the hazard ratio.

RESULTS

Out of 146 patients, 16 died (10.7 %). Most common causes were respiratory distress syndrome, perinatal asphyxia, meconium aspiration and sepsis. Association was found between hyperglycemia and chest compression, metabolic acidemia, hyperlactatemia, mechanical ventilatory support, intraventricular hemorrhage and death.

CONCLUSIONS

Hyperglycemia was an independent risk factor for the prediction of death, with a likelihood of death of 56.8 % when it was present.