scholarly journals Monitoring of Blood Glucose Level in Surgical Intensive Care Unit Patients with Sepsis

2019 ◽  
Vol 87 (9) ◽  
pp. 2977-2981
Author(s):  
ABDULLAH N. EL-ORABY, M.Sc.; SOHAIR M. SOLIMAN, M.D. ◽  
AHMED A. EL-DABA, M.D.; WAIL E. MESBAH, M.D.
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care

Associations between dynamics of the blood glucose level after hypoglycemia and intensive care unit mortality: a retrospective multicenter study

2015 ◽  
Vol 41 (10) ◽  
pp. 1864-1865
Author(s):  
Roosmarijn T. M. van Hooijdonk ◽  
Jan M. Binnekade ◽  
Ameen Abu–Hanna ◽  
Floris van Braam Houckgeest ◽  
Lieuwe S. Hofstra ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Multicenter Study ◽  
Intensive Care Unit Mortality ◽  
Retrospective Multicenter Study

scholarly journals WHAT SHOULD BE THE TARGET BLOOD GLUCOSE LEVEL IN THE INTENSIVE CARE UNIT?

CHEST Journal ◽  
2008 ◽  
Vol 134 (4) ◽  
pp. 59S
Author(s):  
Ashraf Al-Tarifi ◽  
Nabil Abouchala ◽  
Hani Tamim ◽  
Asgar Rishu ◽  
Yaseen Arabi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Target Blood Glucose

Blood Glucose Variability is Associated with Mortality in the Surgical Intensive Care Unit

2008 ◽  
Vol 74 (8) ◽  
pp. 679-685 ◽  
Author(s):  
Lesly A. Dossett ◽  
Hanqing Cao ◽  
Nathan T. Mowery ◽  
Marcus J. Dortch ◽  
John M. Morris ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Insulin Dose ◽  
Standard Of Care ◽  
Glucose Variability ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Blood Glucose Variability ◽  
Surgical Icu

Intensive insulin therapy has widely and rapidly been adopted as the standard of care for the treatment of hyperglycemia in the intensive care unit (ICU). Variability in blood glucose is increasingly recognized as an important factor in outcomes in the chronic diabetic in addition to hemoglobin A1C. We tested the hypothesis that measures of blood glucose variability would be associated with mortality in the surgical ICU. A retrospective analysis of a cohort of ventilated, critically ill surgical and trauma ICU patients placed on an automated insulin protocol was performed. Blood glucose (BG) variability was measured by comparing standard deviation, percentile values, successive changes in blood glucose, and by calculating the triangular index for various glucose-related indices. Eight hundred and fifty-eight patients had 46,474 blood glucose and insulin dose data points. One hundred and twenty-one patients died for an overall mortality rate of 14 per cent. Several measures of blood glucose variability (maximum successive change in BG and the triangular index) were different between the groups despite similar mean BG between survivors (117 mg/dL) and nonsurvivors (118 mg/dL). Increased blood glucose variability is associated with mortality in the surgical ICU. Further studies should focus on the demographic, clinical, and genetic factors responsible for this observation and identify strategies to minimize BG variability.

scholarly journals The Effect Of Controlling Hyperglycemia On The Morbidity And Mortality Of Intensive Care Unit (ICU) Patients

2016 ◽  
Vol 12 (18) ◽  
pp. 184
Author(s):  
Hiyam Al-Haqeesh ◽  
Abla Al-Bsoul ◽  
Hussein Shalan ◽  
Aysha Abedalhameed Al-khalaylah ◽  
Nares Musa Ahmad Hakouz ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Intervention Group ◽  
Target Range ◽  
Control Group ◽  
Management Protocol ◽  
Glucose Management

Introduction: Hyperglycemia and insulin resistance are common in critically ill patients, even if they have not previously had diabetes, and the risk of mortality or significant morbidity is high among those who are treated in the intensive care unit (ICU) for more than 5 days. Objective: To assess the effect of glucose management protocol on mortality and morbidity in a heterogeneous population of critically ill adult patients. Design: A randomized controlled trial. Setting: A 24-bed medical-surgical intensive care unit (ICU) for adult patients at King Hussein Medical Center, the Royal Medical Services. Methods: A total of 50 patients who were considered to need intensive care for at least three days, were randomly assigned into two groups. The intervention group subjects were to undergo a glucose control protocol with insulin infusion titrated to maintain blood glucose level in a target range of 120-160 mg/dL; except septic patients, in whom the target was higher, 160- 180 mg/dL. Patients in the second group (control group) were treated by a conventional approach with reduction of blood glucose level only if the level was markedly elevated (>200 mg/dL) to maintain blood glucose level in a target range of 180-200 mg/dL. Results: After adjustment for baseline characteristics the 2 groups of patients were well matched, for age, sex, prevalence of diabetes mellitus, HbA1c value and distribution of diagnoses; the only significant difference was in the percentage of cardiovascular dysfunction, which was higher in the intervention group (p=0.047). After institution of the protocol, the mean blood glucose levels differed significantly between the two treatment groups during the study period (143.70±12.78 mg/dL in the intervention group versus 175.56±14.07 mg/dL in the control group (p<0.001). And patients in the intervention group received a larger mean insulin dose 28.32 ±16.38 units per day, vs. 14.60±12.26 in the control group (p=0.001). The difference in mortality between the two treatment groups was not significant at 28 days (p=0.370) and at 60 days (p=0.555). No significant increase in hypoglycemia episodes was reported in our blood glucose level target. Conclusion: The glucose management protocol resulted in significantly improved glycemic control and was not associated with increased rate of death or hypoglycemia.

scholarly journals Implementation Of Intervention Program For Controlling Glucose Level Among ICU Patients

2016 ◽  
Vol 12 (18) ◽  
pp. 1
Author(s):  
Hiyam Al-Haqeesh ◽  
Shereen Ziad Alhuneity ◽  
Laith A Obeidat ◽  
Ali Sayel Al Rashaydah ◽  
Jebril Ahmed Albedoor ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Intervention Group ◽  
Target Range ◽  
Control Group ◽  
Management Protocol ◽  
Glucose Management

Introduction: Hyperglycemia and insulin resistance are common in critically ill patients, even if they have not previously had diabetes, and the risk of mortality or significant morbidity is high among those who are treated in the intensive care unit (ICU) for more than 5 days. Study objectives: To assess the effect of glucose management protocol on mortality and morbidity in a heterogeneous population of critically ill adult patients. Methods and materials: Study design: A randomized controlled trial. Study setting: Intensive care unit (ICU) for adult patients at King Hussein Medical Center, the Royal Medical Services. Study sample: A total of 50 patients were included in this study and assigned randomly into two groups, control group (N=25), and intervention group (N=25). Study protocol: The intervention group subjects were to undergo a glucose control protocol with insulin infusion titrated to maintain blood glucose level in a target range of 120-160 mg/dL; except septic patients, in whom the target was higher, 160- 180 mg/dL. Patients in the second group (control group) were treated by a conventional approach with reduction of blood glucose level only if the level was markedly elevated (>200 mg/dL) to maintain blood glucose level in a target range of 180-200 mg/dL Study findings: Although the difference in mortality between the two treatment groups was not significant at 28 days (p=0.370) and at 60 days (p=0.555), but it was to be considered for further improvements. No significant increase in hypoglycemia episodes was reported in our blood glucose level target. There was no significant difference in the development of new organ failure, new renal insufficiency, number of patients undergoing transfusion of packed red blood cells, use of antibiotics for more than 10 days, length of stay in the ICU and length of stay in the hospital. It was noticed that the rates of positive blood cultures were lower in the interventional group (8%) than in the control group (32), (p=0.068). Conclusion: The glucose management protocol resulted in significantly improved glycemic control and was not associated with increased rate of death or hypoglycemia.

scholarly journals Insulin Sensitivity and Blood Glucose Level of Sepsis Patients in the Intensive Care Unit

2018 ◽  
Author(s):  
Fatanah M. Suhaimi ◽  
Ummu K. Jamaludin ◽  
Normy N. A. Razak ◽  
Mohd Basri Mat Nor ◽  
Azrina M. Ralib ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Insulin Sensitivity ◽  
Blood Glucose Level ◽  
Glucose Level

Hypoglycemia in a Surgical Intensive Care Unit

2021 ◽  
pp. 000313482110249
Author(s):  
Emily Switzer ◽  
Morgan Schellenberg ◽  
Meghan Lewis ◽  
Natthida Owattanapanich ◽  
Lydia Lam ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Blood Glucose ◽  
High Risk ◽  
Soft Tissue ◽  
Surgical Intensive Care Unit ◽  
Subcutaneous Insulin ◽  
Surgical Intensive Care ◽  
Long Acting

Background Glycemic control is an important aspect of critical care because derangements are associated with morbidity and mortality. Patients at highest risk for hypoglycemia in the surgical intensive care unit (SICU) are incompletely described by existing literature. Our objective was to delineate this high-risk patient population in our SICU. Study Design In this single-center, retrospective, observational study, SICU patients admitted from June 1, 2019 to July 31, 2020 with ≥1 episode of hypoglycemia (blood glucose <60 mg/dL) were included. Results There were 41 hypoglycemic events in 27 patients, comprising an incidence of 1.5% among SICU patients. The most common admission diagnoses were cirrhosis (n = 13, 48%), polytrauma (n = 12, 44%), multisystem organ failure (n = 11, 41%), diabetes mellitus (n = 9, 33%), and soft tissue infection (n = 8, 30%). Four high-risk populations were identified: patients in multisystem organ failure (MSOF) (n = 11, 41%); those who were nil per os (NPO) (n = 10, 37%); patients receiving long acting subcutaneous insulin, for example, Lantus (n = 3, 11%); and those on continuous intravenous insulin infusions (n = 3, 11%). After multi-disciplinary peer review, most hypoglycemic events (n = 16, 59%) were deemed iatrogenic. Conclusions Hypoglycemia is rare in surgical critical care. When it does occur, patients are typically in MSOF, NPO, on long acting subcutaneous insulin or continuous insulin infusions, have soft tissue infections, or have acute or chronic liver failure. Increased vigilance with frequent blood glucose monitoring in these high-risk patients may reduce the risk of hypoglycemia in the SICU.

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