BACKGROUND: @entity4854 is commonly associated with the hypermetabolic stress response. However, persistent @entity4854 may adversely affect wound healing and immunity. The purpose of this study was to assess any relationship between @entity4854 and clinical outcome after severe @entity130 . METHODS: Survey of the medical records from January 1996 to July 1999 identified 58 pediatric @entity1 with burns > or = 60% body surface. @entity1 were categorized as having poor @entity413 control (n = 33) if > or = 40% of all plasma @entity413 determinations were > or = 7.8 mmol/L (140 mg/dL) and compared with @entity1 deemed to have adequate @entity413 control (n = 25) in whom > or = 40% of all @entity413 values were > or = 7.8 mmol/L. RESULTS: Despite similar age, burn size, caloric intake, and frequency of @entity2737 , @entity1 categorized with poor @entity413 control had a significantly greater incidence of positive @entity1503 (positive @entity1503 /length of stay days, 0.42 +/- 0.04 for @entity4854 @entity1 vs. 0.30 +/- 0.03 for normoglycemia @entity1 ; mean +/- SEM, p > or = 0.05). This finding was especially prominent for @entity1503 positive for @entity375 . @entity4854 @entity1 had significantly less percentage of skin graft take than did the normoglycemic @entity1 (percent take/operative procedure, 64 +/- 9 for @entity4854 @entity1 vs. 88 +/- 5 for normoglycemia @entity1 ; p < 0.05). Nine @entity1 (27%) with persistent @entity4854 died compared with only one @entity204 (4%) in @entity1 with adequate @entity413 control (p > or = 0.05). CONCLUSION: This association between poor @entity413 control, @entity2259 / @entity12045 , reduced skin graft take, and subsequent mortality in severely burned @entity1 may be related to a @entity4854 -induced detriment in antimicrobial defense. Although this report fails to establish cause and effect, these findings suggest that aggressive maneuvers to normalize plasma @entity413 in critically injured @entity1 may be warranted.

Association of @entity4854 with increased mortality after severe XXXX .

@entity1 :: ('9606', 'Species') :: ['children', 'Patients', 'patients'] @entity2737 :: ('MESH:D014946', 'Disease') :: ['wound infection'] @entity1503 :: ('MESH:D006402', 'Disease') :: ['blood cultures'] @entity12045 :: ('MESH:D016469', 'Disease') :: ['fungemia'] @entity375 :: ('4932', 'Species') :: ['yeast'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity4854 :: ('MESH:D006943', 'Disease') :: ['hyperglycemia', 'Hyperglycemia'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose'] @entity130 :: ('MESH:D014947', 'Disease') :: ['burn injury'] @entity2259 :: ('MESH:D016470', 'Disease') :: ['bacteremia']
@entity130 :: (MESH:D014947,Disease) :: ['burn injury']
