This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.To evaluate the efficacy of strict glycemic control in pediatric critical care patients we propose a randomized, controlled study in cardiac surgery patients. Enrolled patients will be randomized to either tight glycemic control post-operatively in the cardiac intensive care unit (CICU) with intravenous insulin infusions, the 'euglycemia group', or to standard care where hyperglycemia is not treated with insulin infusions, the 'control group.' To allow tight glycemic control while ensuring safety of our intervention, continuous glucose monitors will be used to prevent and promptly detect any hypoglycemia in both groups. Based on the high incidence of stress hyperglycemia in this population and the dramatic decrease in morbidity in critically ill adult patients with tight glycemic control, we hypothesize that our intervention may decrease nosocomial infection incidence and CICU length of stay, and in addition improve both cardiac function and nutritional indices in those children treated to maintain euglycemia.
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