scholarly journals Prognostic Value of Admission Blood Glucose Level in Critically Ill Patients Admitted to Cardiac Intensive Care Unit according to the Presence or Absence of Diabetes Mellitus

2019 ◽  
Vol 34 (9) ◽  
Author(s):  
Sua Kim ◽  
Soo Jin Na ◽  
Taek Kyu Park ◽  
Joo Myung Lee ◽  
Young Bin Song ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Critically Ill Patients ◽  
Prognostic Value ◽  
Cardiac Intensive Care Unit ◽  
Cardiac Intensive Care

Abstract 15293: Noninvasive Echocardiographic Cardiac Power Output Predicts Mortality in Cardiac Intensive Care Unit Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Barry Burstein ◽  
Vidhu Anand ◽  
Bradley Ternus ◽  
Meir Tabi ◽  
Nandan S Anavekar ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Power Output ◽  
Critically Ill Patients ◽  
Cardiac Intensive Care Unit ◽  
Cardiac Power ◽  
The Mean ◽  
Cardiac Intensive Care

Introduction: A low cardiac power output (CPO), measured invasively, identifies critically ill patients at increased risk of mortality. CPO can also be measured non-invasively with transthoracic echocardiography (TTE), although prognostic data in critically ill patients is not available. Hypothesis: Reduced CPO measured by TTE is associated with increased hospital mortality in cardiac intensive care unit (CICU) patients. Methods: Using a database of CICU patients admitted between 2007 and 2018, we identified patients with TTE within one day (before or after) of CICU admission who had data necessary for calculation of CPO. Multivariable logistic regression determined the relationship between CPO and adjusted hospital mortality. Results: We included 5,585 patients with a mean age of 68.3±14.8 years, including 36.7% females. Admission diagnoses included acute coronary syndrome (ACS) in 57%, heart failure (HF) in 50%, cardiac arrest (CA) in 12%, and cardiogenic shock (CS) in 13%. The mean left ventricular ejection fraction (LVEF) was 47±16%, and the mean CPO was 1.0±0.4 W. CPO was inversely associated with the risk of hospital mortality (Figure A), including among patients with ACS, HF, and CS (Figure B). On multivariable analysis, lower CPO was associated with higher hospital mortality (OR 0.96 per 0.1 W, 95% CI 0.0.93-0.99, p=0.03). Hospital mortality was highest in patients with low CPO coupled with reduced LVEF, increased vasopressor requirements, or higher admission lactate. Hospital mortality was higher among patients with a CPO <0.6 W (adjusted OR 1.57, 95% CI 1.13-2.19, p = 0.007), particularly in the presence of admission lactate level >4 mmol/L (50.9%). Conclusions: Echocardiographic CPO was inversely associated with hospital mortality in CICU patients, particularly among patients with increased lactate and vasopressor requirements. Routine measurement of CPO provides important information beyond LVEF and should be considered in CICU patients.

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

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

The Prognostic Value of Lactate in Cardiac Intensive Care Unit Patients with Cardiac Arrest and Shock

Shock ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Barry Burstein ◽  
Saraschandra Vallabhajosyula ◽  
Bradley Ternus ◽  
Gregory W. Barsness ◽  
Kianoush Kashani ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Prognostic Value ◽  
Cardiac Intensive Care Unit ◽  
Cardiac Intensive Care

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.

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