H Karamifar - Assistant professor
SH Mehranband

The aim of this study was to determine the prevalence and clinical characteristics associated with stress Hyperglycemia among patients attending to the neonatal and pediatric Emergency wards. Patients who require d blood sampling for evaluated of an acute illness from August ۱۹۹۵ to July ۱۹۹۶ to the Namazi hospital of Shiraz medical university were enrolled prospectively for Hyperglycemia ( plasma glucose>۱۵۰ mg/ DL). A total of ۱۶۲۰ patients ranging from ۳ days to ۱۶ years were enrolled. Plasma glucose values ranged from ۲۹ mg/ DL to ۵۹۳ mg/ DL. ۲۰۶ patients (۱۲.۷℅) had Hyperglycemia. The prevalence of stress Hyperglycemia was significantly higher among patients if they: ۱. Were neonates and infants <۲ year (۲۰.۲۲℅) versus older children ۲_۶ year ,(۹.۸℅), ۶_۱۲ year (۳.۲۵℅) and adolescents ۱۲_۱۶ year (۵.۱℅) ( p<۰.۰۰۱). ۲. Had acut illnesses (۲۷.۲℅) versus more chronic disease (۶.۸℅) ( p<۰.۰۰۱). ۳. Several dehydrated (۷۵.۹℅) versus not several dehydrated (۱۰.۴℅) ( p<۰.۰۰۱).۴. had convulsions in their  recent illness (۲۹.۷℅) versus not having convulsions (۸.۵℅) ( p<۰.۰۰۱). ۵. Had vomiting and diarrhea in recent illness (۴۰.۳℅) versus not having vomiting and diarrhea (۹.۱℅) ( p<۰.۰۰۱). ۶. Had unstable vital signs (۴۴.۳℅) versus stable vital signs (۷.۵℅) ( p<۰.۰۰۱).۷. had been admitted to an intensive care unit, neonatal ICU (۸۰℅), pediatric ICU (۶۲.۵℅) and neonatal Emergency room (۲۱.۸℅) ( p<۰.۰۲). It is concluded that stress Hyperglycemia is a frequent clinical occurrence in a pediatric emergency departments, and it does not appear to be specifically associated with any particular disease but is significantly related to  the severity , acuity of the illness and state of hydration of the patient.

Hyperglycemia, Stress, neonates, Pediatrics