scholarly journals Stress Hyperglycemia: A Problem that Cannot be Ignored

2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Daxu Peng ◽  
Yifan Zhang ◽  
Xiuyang Cao ◽  
Jianyi Pu
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Severe Infection ◽  
Glucose Metabolism Disorders ◽  
Stress Hyperglycemia ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Pathological Mechanism ◽  
Serious Infections ◽  
Mechanical Ventilation Time

Stress hyperglycemia is a strong neuroendocrine reaction in thehypothalamic pituitary adrenal cortex under severe infection, trauma, burns,hemorrhage, surgery and other harmful stimulated, resulting in increasedsecretion of counter-regulatory hormones. These hormones promotedthe production of sugar and cause glucose metabolism disorders withcytokines and insulin resistance. In this condition, the production of sugarexceeds the utilization of sugar by the tissues, which eventually leads to anincrease in blood glucose levels in plasma. In the intensive care unit, stresshyperglycemia is very common and can occur in patients with or withoutdiabetes. The incidence is as high as 96%, and it is an independent factorin the death of critically ill patients. Hyperglycemia not only prolongsthe hospitalization time, mechanical ventilation time and increased theincidence of serious infections in critically ill patients, but can also leadto the occurrence of type 2 diabetes. Therefore, it is very important tolearn the pathological mechanism of stress hyperglycemia, the harm ofhyperglycemia and blood sugar management.

scholarly journals Understanding safety differently: developing a model of resilience in the use of intravenous insulin infusions in hospital in-patients—a feasibility study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029997
Author(s):  
Mais Hasan Iflaifel ◽  
Rosemary Lim ◽  
Kath Ryan ◽  
Clare Crowley ◽  
Rick Iedema
Keyword(s):  
Blood Glucose ◽  
Phase I ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Insulin Infusion ◽  
University Hospitals ◽  
Glucose Levels ◽  
Oxford University ◽  
Intravenous Insulin ◽  
Blood Glucose Levels

BackgroundIntravenous insulin infusions are considered the treatment of choice for critically ill patients and non-critically ill patients with persistent raised blood glucose who are unable to eat, to achieve optimal blood glucose levels. The benefits of using intravenous insulin infusions as well as the problems experienced are well described in the scientific literature. Traditional approaches for improving patient safety have focused on identifying errors, understanding their causes and designing solutions to prevent them. Such approaches do not take into account the complex nature of healthcare systems, which cannot be controlled solely by following standards. An emerging approach called Resilient Healthcare proposes that, to improve safety, it is necessary to focus on how work can be performed successfully as well as how work has failed.Methods and analysisThe study will be conducted at Oxford University Hospitals NHS Foundation Trust and will involve three phases. Phase I: explore how work is imagined by analysing intravenous insulin infusion guidelines and conducting focus group discussions with guidelines developers, managers and healthcare practitioners. Phase II: explore the interplay between how work is imagined and how work is performed using mixed methods. Quantitative data will include blood glucose levels, insulin infusion rates, number of hypoglycaemic and hyperglycaemic events from patients’ electronic records. Qualitative data will include video reflexive ethnography: video recording healthcare practitioners using intravenous insulin infusions and then conducting reflexive meetings with them to discuss selected video footage. Phase III: compare findings from phase I and phase II to develop a model for using intravenous insulin infusions.Ethics and disseminationEthical approvals have been granted by the South Central—Oxford C Research Ethics Committee, Oxford University Hospitals NHS Foundation Trust and University of Reading. The results will be disseminated through presentations at appropriate conferences and meetings, and publications in peer-reviewed journals.

scholarly journals The impact of the blood glucose levels of non-diabetic critically ill patients on their clinical outcome

2018 ◽  
Vol 50 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Leonid Koyfman ◽  
Evgeni Brotfain ◽  
Alexander Erblat ◽  
Inna Kovalenko ◽  
Yair-Yaish Reina ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Clinical Outcome ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
The Impact

Effects of Different Blood Glucose Levels on Critically Ill Patients in an Intensive Care Unit

2015 ◽  
Vol 25 (6) ◽  
pp. 388-393 ◽  
Author(s):  
Li Kang ◽  
Juan Han ◽  
Qun-Cao Yang ◽  
Hui-Lin Huang ◽  
Nan Hao
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Fasting Blood Glucose ◽  
Apache Ii Score ◽  
High Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels

<b><i>Aims:</i></b> We explore the infection incidence and possible prognostic outcome relevance for patients with different blood glucose levels in an intensive care unit (ICU). <b><i>Methods:</i></b> A total of 98 cases were enrolled and divided into three groups based on average fasting blood glucose levels (group A: ≤6.1 mmol/l; group B: 6.1-10 mmol/l; group C: ≥10 mmol/l). <b><i>Results:</i></b> There were no statistical differences in the time to ICU admission, the indwelling durations of gastric tubes, urinary or deep vein catheters, tracheal intubations and tracheotomies, or the length of ventilator use (all p > 0.05). No evident difference in the multiple organ dysfunction syndrome rate was found between the three groups (p = 0.226). The infection and mortality rates between the groups showed significant differences (all p < 0.05). Furthermore, the difference of respiratory system infections was statistically significant among the three groups (p = 0.008), yet no such statistical difference was observed among groups regarding nonrespiratory system infections (p = 0.227). <b><i>Conclusions:</i></b> Critically ill patients with a high blood glucose level were positively correlated with a relatively high APACHE II score and more serious degree of disease, as well as a higher incidence of respiratory infection during their ICU stay than those with lower blood glucose levels (<10 mmol/l).

scholarly journals Hyperactive Delirium and Blood Glucose Control in Critically Ill Patients

2007 ◽  
Vol 35 (5) ◽  
pp. 666-677 ◽  
Author(s):  
A Heymann ◽  
M Sander ◽  
D Krahne ◽  
M Deja ◽  
S Weber-Carstens ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Metabolic Disorders ◽  
Blood Glucose Control ◽  
Apache Ii Score ◽  
Complication Rates ◽  
Icu Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels

Delirium is a common complication of critically ill patients and is often associated with metabolic disorders. One of the most frequent metabolic disorders in intensive care unit (ICU) patients is hyperglycaemia. The aim of this retrospective study of 196 adult ICU patients was to determine if there is an association between hyperactive delirium and blood glucose levels in ICU patients. Hyperactive delirium was diagnosed using the delirium detection score. Blood glucose levels were monitored by blood gas analysis every 4 h. Hyperactive delirium was detected in 55 (28%) patients. Delirious patients showed significantly higher blood glucose levels than non-delirious patients Higher overall complication rates, length of ventilation, ICU stay and mortality rates were seen in the delirium group. In a multivariate analysis, glucose level, alcohol abuse, APACHE II score, complication by hospital-acquired pneumonia and a diagnosis of polytrauma on-admission all significantly influenced the appearance of delirium.

Closed Loop Glycemic Control in Critically Ill Patients: Feasibility Study and Experimental Design

2007 ◽  
Author(s):  
Alexandra Oliveros ◽  
Josep Vehí ◽  
Alfredo Gutiérrez ◽  
Winston García-Gabín
Keyword(s):  
Blood Glucose ◽  
Experimental Design ◽  
Glycemic Control ◽  
Critically Ill ◽  
Feasibility Study ◽  
Critically Ill Patients ◽  
Closed Loop ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Increased Risk

Some studies, published recently, affirm that blood glucose levels are closely related with an increased risk in the moratality of critically ill patients [1].

scholarly journals Predicting Mortality of Critically Ill Patients by Blood Glucose Levels

2013 ◽  
Vol 37 (5) ◽  
pp. 385 ◽  
Author(s):  
Byung Sam Park ◽  
Ji Sung Yoon ◽  
Jun Sung Moon ◽  
Kyu Chang Won ◽  
Hyoung Woo Lee
Keyword(s):  
Blood Glucose ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels
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