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Endocrinologic Diseases in Pediatric Cardiac Intensive Care

Soto-Rivera, Carmen L. MD1; Schwartz, Steven M. MD, FRCPC2; Sawyer, Jaclyn E. PharmD3; Macrae, Duncan J. MBChB, FRCA, FRCPCH4; Agus, Michael S. D. MD5

Pediatric Critical Care Medicine: August 2016 - Volume 17 - Issue 8 - p S296-S301
doi: 10.1097/PCC.0000000000000827
Organ Systems: Other Organ Systems and Systemic Disorders

Objectives: The objectives of this review are to discuss the pathophysiology, clinical impact and treatment of hyperglycemia, and disturbances in thyroid and adrenal function prior to and following cardiac surgery in children.

Data Source: MEDLINE and PubMed.

Conclusions: Disturbances in glucose metabolism and thyroid and adrenal function are common in critically ill children with cardiac disease and in particular in children undergoing cardiac surgery for complex congenital heart disease. An understanding of the pathophysiology, clinical impact and treatment of these disturbances is essential for the management of these at risk patients.

1Department of Pediatrics, Section of Endocrinology, Harvard Medical School, Boston Children’s Hospital, Boston, MA.

2Department of Pediatrics, Section of Critical Care Medicine and Cardiology, Section of Cardiac Critical Care Medicine, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada.

3Division of Pharmacy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

4Pediatric Critical Care, Royal Brompton Hospital, London, United Kingdom.

5Division of Medicine Critical Care, Department of Pediatrics, Harvard Medical School, Boston Children’s Hospital, Boston, MA.

Dr. Soto-Rivera received funding (as a consultant for Marinus Pharmaceutical which develops anti-seizure medications). Dr. Schwartz received funding from Novartis AG and from Health Outcomes International. Dr. Agus received support for article research from the National Institutes of Health and disclosed off-label product use (Use of a subcutaneous continuous glucose monitor in ICU patients). The remaining authors have disclosed that they do not have any potential conflicts of interest.

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Copyright © 2016 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies