Review of a Large Clinical Series: Insulin Resistance Despite Tight Glucose Control Is Associated With Mortality in Critically Ill Surgical Patients

2009 ◽  
Vol 24 (4) ◽  
pp. 242-251 ◽  
Author(s):  
Nathan T. Mowery ◽  
Marcus J. Dortch ◽  
Lesly A. Dossett ◽  
Patrick R. Norris ◽  
Jose J. Diaz ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Critically Ill ◽  
Glucose Control ◽  
Surgical Patients ◽  
Tight Glucose Control ◽  
Clinical Series ◽  
Critically Ill Surgical Patients

INSULIN RESISTANCE DESPITE TIGHT GLUCOSE CONTROL IS ASSOCIATED WITH MORTALITY IN CRITICALLY ILL SURGICAL PATIENTS.

2006 ◽  
Vol 34 ◽  
pp. A11 ◽  
Author(s):  
Nathan T Mowery ◽  
Asli Ozdas ◽  
Marcus Dortch ◽  
Patrick R Norris ◽  
Rafe Donahue ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Critically Ill ◽  
Glucose Control ◽  
Surgical Patients ◽  
Tight Glucose Control ◽  
Critically Ill Surgical Patients

Glucose Control by Insulin for Critically Ill Surgical Patients

2004 ◽  
Vol 57 (5) ◽  
pp. 1132-1138 ◽  
Author(s):  
Wisam Khoury ◽  
Joseph M. Klausner ◽  
Ron Ben-Abraham ◽  
Oded Szold
Keyword(s):  
Critically Ill ◽  
Glucose Control ◽  
Surgical Patients ◽  
Critically Ill Surgical Patients

Glucose Metabolism, Not Obesity, Predicts Mortality in Critically Ill Surgical Patients

2010 ◽  
Vol 76 (12) ◽  
pp. 1377-1383 ◽  
Author(s):  
Nathan T. Mowery ◽  
Addison K. May ◽  
Bryan C. Collier ◽  
Lesly A. Dossett ◽  
Oliver L. Gunter ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Critically Ill ◽  
Odds Ratio ◽  
Primary Outcome ◽  
Independent Predictor ◽  
Insulin Dose ◽  
Surgical Patients ◽  
Surgical Critical Care ◽  
Automated Protocol ◽  
Critically Ill Surgical Patients

Our hypothesis was to determine if insulin resistance and hyperglycemia, rather than obesity, are predictive of mortality in the surgically critically ill. An observational study of an automated protocol in surgical and trauma intensive care units was performed. Two groups were created based on body mass index (BMI): Obese (OB) defined as BMI ≥ 30 (n = 338) and nonobese defined as BMI < 30 (n = 885). Euglycemia was maintained using an automated protocol using an adapting multiplier, which we used as our marker of stress insulin resistance. The primary outcome was hospital mortality. One thousand, two hundred and twenty-three patients met criteria with 73,225 glucose values. The OB group required more insulin (4.5 U/hr vs 3.2 U/hr, P ≤ 0.01) and had a higher mean multiplier (0.07 vs 0.06, P < 0.01) reflecting insulin resistance. There was no difference in mortality between OB and nonobese (11.6% vs 11.5%, P = 0.96). Logistic regression showed that insulin dose (odds ratio 0.864; 95% confidence interval 0.772-0.967, P = 0.01), and not BMI, was an independent predictor of survival in this population. Obesity is not an independent risk factor for mortality in the surgical critical care population. Insulin resistance and subsequent hyperglycemia are increased in obesity and are independent predictors of mortality.

Group II phospholipase A2 in serum in critically ill surgical patients

1994 ◽  
Vol 22 (6) ◽  
pp. 956-959 ◽  
Author(s):  
JUHA M. GröNROOS ◽  
KARI KUTTILA ◽  
TIMO J. NEVALAJNEN
Keyword(s):  
Phospholipase A2 ◽  
Critically Ill ◽  
Surgical Patients ◽  
Group Ii ◽  
Critically Ill Surgical Patients

Epidemiology of severe sepsis in critically ill surgical patients in ten university hospitals in China*

2007 ◽  
Vol 35 (11) ◽  
pp. 2538-2546 ◽  
Author(s):  
Baoli Cheng ◽  
Guohao Xie ◽  
ShangLong Yao ◽  
Xinmin Wu ◽  
Qulian Guo ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Critically Ill ◽  
Surgical Patients ◽  
University Hospitals ◽  
Critically Ill Surgical Patients
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