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The HALF-PINT study enrolls children in the intensive care unit (ICU) with high blood sugar who need blood pressure medication or are on a machine to help them breathe. These patients are among those with the highest risk of doing poorly and staying the longest in the ICU. Medical studies have linked high blood sugar to increased risk of death and more complicated hospital stays in children in the ICU. Treating high blood sugar levels to keep them in a normal range may reduce these risks and improve your child’s hospital course.

When a patient’s blood sugar is too high, giving insulin helps to lower the blood sugar. Insulin is a natural substance that we all have in our bodies and is made by an organ called the pancreas. It helps the body use blood sugar by helping the sugar enter the body’s cells. Children who are very sick often do not produce enough insulin on their own to keep their blood sugar at a normal level. The nurse who is caring for a patient in the study will closely monitor his or her blood sugar, giving insulin when needed to lower the blood sugar and giving sugar when needed to raise the blood sugar.

The study will be conducted in approximately 35 ICUs throughout the world and will enroll about 1,414 children over a period of approximately 6 years. Dr. Michael Agus of Boston Children’s Hospital and Dr. Vinay Nadkarni of the Children’s Hospital of Philadelphia are coordinating this research in partnership with ICU doctors at many other hospitals around the country.

The purpose of this research study is to find out if close management of blood sugar in a sick child will speed up his or her recovery. We will study this by comparing two different levels of blood sugar management. We will use insulin, given together with the usual nutrition provided in the ICU, to lower the child’s blood sugar so that it stays in one of the two target ranges. The two tight glycemic control (TGC) target ranges that the patient will be randomly selected to receive are TGC-1 (80-110 mg/dL) or TGC-2 (150-180 mg/dL). Both of the blood sugar target ranges being studied in HALF-PINT are being used in many ICUs around the country for both adults and children, and fall under usual ICU care. This study will examine differences in survival, organ failure, the length of ICU stay, and brain function in children with high blood sugar and critical illness.