However, each individual chosen to represent their group for this selleck chemical DZNeP study had the opportunity to discuss our survey questions with other members of their group to ensure responses adequately reflected those of their center.Lastly, it is notable that results from at least two important studies in this field were published during the time this survey was conducted, specifically the aforementioned pediatric glycemic control trial by Vlasselaers et al, and more recently the results from the NICE-SUGAR investigators [15,23]. These studies potentially may have influenced current practice habits in participating centers. Findings from these studies add to the debate and controversy regarding strict versus conventional glycemic control, outcome improvements, and goal target BG levels in adult and pediatric populations.

It is important to recognize that results from our survey represent a snap-shot of current trends in pediatric glycemic control, and that in this ever-evolving field, beliefs and practices will likely continue to change as more data becomes available to guide evidence-based practice.ConclusionsIn summary, we find that there exists a significant awareness of hyperglycemia in pediatric ICU practice, but that few have modified their group practice to reflect their current beliefs. In general, pediatric intensivists may benefit from revisiting and staying abreast of the current state of literature regarding both hyper and hypoglycemia in critically ill children, and we recommend that all pediatric practitioners should consider treating hyperglycemia in their older, adult patients, such as those >18 years old, as suggested by multiple medical advisory groups.

It may be premature to recommend the widespread adoption of glycemic control measures in all critically ill children on the basis of outcome studies, but for those centers that do practice glycemic control, there may be other quality and safety reasons to develop a center-consistent approach to this management. Support and encouragement of future studies to develop and validate safe and effective pediatric-specific approaches to glycemic control, and to assess whether this management impacts outcomes in critically ill children will be of utmost importance.Key messages? Hyperglycemia is common in critically ill patients, is associated with increased morbidity and mortality, and strict glycemic control with insulin may improve outcomes in some populations.? Most adult institutions have adopted regular approaches for glycemic control, and although the optimal goal BG target is unclear, many medical advisory committees recommend that AV-951 at least some degree of glycemic control should be part of regular practice.