Read by QxMD icon Read

glucose control in icu

Sarah J Beesley, Eliotte L Hirshberg, Michael J Lanspa
In a recently published issue of Critical Care Medicine, Kar and colleagues investigated glucose management of critically ill patients with type 2 diabetes. In this commentary, we discuss the challenges of investigating glucose control in the critically ill, why so many internally valid studies in this field lead to conflicting results, and the obstacles preventing investigators from reaching a conclusive answer.
September 2016: Annals of Translational Medicine
Manasi Hulyalkar, Stephen J Gleich, Rahul Kashyap, Amelia Barwise, Harsheen Kaur, Yue Dong, Lei Fan, Srinivas Murthy, Grace M Arteaga, Sandeep Tripathi
Increasing process complexity in the pediatric intensive care unit (PICU) can lead to information overload resulting in missing pertinent information and potential errors during morning rounds. An efficient model using a novel electronic rounding tool was designed as part of a broader critical care decision support system-checklist for early recognition and treatment of acute illness and injury in pediatrics (CERTAINp). We aimed to evaluate its impact on improving the process of care during rounding. Prospective pre- and post-interventional data included: team performance baseline assessment, patient safety discussion, guideline adherence, rounding time, and a survey of Residents' and Nurses' perception using a Likert scale...
October 18, 2016: Journal of Clinical Monitoring and Computing
E B Carter, M G Tuuli, A O Odibo, G A Macones, A G Cahill
OBJECTIVE: To investigate the association between the number of prenatal visits (PNVs) and pregnancy outcomes in women with gestational diabetes (GDM) and Type 2 diabetes mellitus (DM). STUDY DESIGN: A 4-year prospective cohort study of women with GDM and DM and was conducted. Patients ⩾75th percentile for number of PNVs were compared with those ⩽25th percentile. The primary outcomes were large for gestational age (LGA) with birth weight >90% and neonatal intensive care unit (NICU) admission for >24 h...
October 13, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Kirsten S Deemer, George F Alvarez
Mauriac syndrome is a rare disorder that can present with the single feature of glycogenic hepatopathy in children and adults with poorly controlled diabetes mellitus. An often underrecognized finding of glycogenic hepatopathy is lactic acidosis and hyperlactatemia. Primary treatment of glycogenic hepatopathy is improved long-term blood glucose control. Resolution of symptoms and hepatomegaly will occur with improvement in hemoglobin A1C. We present here a case of a young adult female presenting to the intensive care unit with Mauriac syndrome...
2016: Case Reports in Critical Care
Astrid Balança
OBJECTIVE: We report an emphysematous cystitis in a diabetic patient complicated by peritonitis. OBSERVATIONS: A 66-year-old male presented to the emergency with septic shock. Patient's history: poorly controlled diabetes and prostate adenoma. Clinical examination revealed a surgical abdomen and signs of shock. Blood sugar was 6g/L. CRP 274mg/L. The abdomino-pelvic CT scan showed a perforated bladder with emphysema of the bladder wall and endoluminal air bubbles...
September 2016: Annals of Physical and Rehabilitation Medicine
S N Narla, M Jones, K L Hermayer, Y Zhu
Maintaining blood glucose concentration within an acceptable range is a goal for patients with diabetes mellitus. Point-of-care glucose meters initially designed for home self-monitoring in patients with diabetes have been widely used in the hospital settings because of ease of use and quick reporting of blood glucose information. They are not only utilized for the general inpatient population but also for critically ill patients. Many factors affect the accuracy of point-of-care glucose testing, particularly in critical care settings...
2016: Advances in Clinical Chemistry
Tomohide Yamada, Nobuhiro Shojima, Hisashi Noma, Toshimasa Yamauchi, Takashi Kadowaki
PURPOSE: It is unclear whether tight glycemic control is warranted in all critically ill adults. We employed network meta-analysis to examine the risk of mortality and hypoglycemia associated with different glycemic control targets in critically ill adults. METHODS: Electronic databases were searched up to 2016 for randomized controlled trials comparing various insulin regimens in critically ill adults with hyperglycemia. Two reviewers independently extracted information and evaluated quality with the Cochrane risk-of-bias tool...
September 16, 2016: Intensive Care Medicine
Nora Luethi, Luca Cioccari, Marco Crisman, Rinaldo Bellomo, Glenn M Eastwood, Johan Mårtensson
BACKGROUND: It is uncertain whether liberal glucose control in critically ill diabetic patients leads to increased ketone production and ketoacidosis. Therefore, we aimed to assess the prevalence of ketosis, ketonuria and ketoacidosis in critically ill diabetic patients treated in accordance with a liberal glycemic control protocol. METHODS: We performed a prospective observational cohort study of 60 critically ill diabetic patients with blood and/or urine ketone bodies tested in ICU...
2016: Critical Care: the Official Journal of the Critical Care Forum
Lily E Johnston, Jennifer L Kirby, Emily A Downs, Damien J LaPar, Ravi K Ghanta, Gorav Ailawadi, Benjamin D Kozower, Irving L Kron, Anthony L McCall, James M Isbell
BACKGROUND: Hypoglycemia is a known risk of intensive postoperative glucose control in patients undergoing cardiac operations. However, neither the consequences of hypoglycemia relative to hyperglycemia, nor the possible interaction effects, have been well described. We examined the effects of postoperative hypoglycemia, hyperglycemia, and their interaction on short-term morbidity and mortality. METHODS: Single-institution Society of Thoracic Surgeons (STS) database patient records from 2010 to 2014 were merged with clinical data, including blood glucose values measured in the intensive care unit (ICU)...
August 25, 2016: Annals of Thoracic Surgery
Korkut Daglar, Ozgür Kara, Gülenay Gençosmanolu Türkmen, Ayse Kırbas, Ebru Hacer Biberoğlu, Cem Yasar Sanhal, Nuri Danisman
The present study aimed to analyse the perinatal outcomes in patients with normal 50-g Glucose Challenge Test but who are considered retrospectively to have gestational diabetes mellitus based on elevated fasting plasma glucose (FPG) levels according to recent criteria. The study was conducted between January 2010 and December 2014 to identify patients with FPG values >92 mg/dl and GCT values <130 mg/dl. The patients were divided into two groups: those with FPG values between 92 and 99 mg/dl (Group 1) and those with FPG values >99 mg/dl (Group 2)...
August 26, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Stephen F Quevedo, Marit L Bovbjerg, Randi L Kington
OBJECTIVE: To evaluate the effectiveness of fetal abdominal circumference-guided therapy for gestational diabetes (GDM) in an outpatient population characterized by highly-prevalent maternal obesity. METHODS: Data for this translational retrospective cohort study come from medical records. Fetal abdominal circumference was assessed by ultrasound in late second trimester, and sex- and gestational age-specific percentiles assigned. Taking fetal abdominal circumference percentile as a marker for adequacy of fetal growth, maternal glucose targets were set accordingly: loose, moderate or tight...
August 23, 2016: Journal of Maternal-fetal & Neonatal Medicine
Yunjiao J Wang, Stacey Seggelke, R Matthew Hawkins, Joanna Gibbs, Mark Lindsay, Ingrid Hazlett, Cecilia C Low Wang, Neda Rasouli, Kendra A Young, Boris Draznin
OBJECTIVE: To improve glycemic control of hospitalized patients with diabetes and hyperglycemia, many medical centers have established dedicated glucose management teams (GMT). However, the impact of these specialized teams on clinical outcomes has not been evaluated. METHODS: We conducted a retrospective study of 440 patients with type 2 diabetes admitted to the medical service for cardiac or infection-related diagnosis. The primary endpoint was a composite outcome of several well-recognized markers of morbidity, consisting of: death during hospitalization, transfer to ICU, initiation of enteral or parenteral nutrition, line infection, new in-hospital infection or infection lasting more than 20 days of hospitalization, deep venous thrombosis or pulmonary embolism, rise in plasma creatinine, and hospital readmissions...
August 19, 2016: Endocrine Practice
Nam K Tran, Zachary R Godwin, Amanda N Steele, Steven E Wolf, Tina L Palmieri
OBJECTIVES: The goal of this study was to retrospectively evaluate the clinical impact of an accurate autocorrecting blood glucose monitoring system in children with severe burns. Blood glucose monitoring system accuracy is essential for providing appropriate intensive insulin therapy and achieving tight glycemic control in critically ill patients. Unfortunately, few comparison studies have been performed to evaluate the clinical impact of accurate blood glucose monitoring system monitoring in the high-risk pediatric burn population...
September 2016: Pediatric Critical Care Medicine
HyunSoo Oh, EunKyoung Bae, SeonYoung Lim, JiHye Oh, SunYoung Han, WhaSook Seo
AIMS AND OBJECTIVES: This study was conducted to determine temporal patterns of early changes in physiological parameters of systemic inflammatory response syndrome over three days prior to a diagnosis of sepsis. BACKGROUND: Early detection and timely management of systemic inflammatory response syndrome are often not implemented due to a failure to recognise or diagnose systemic inflammatory response syndrome. DESIGN: A retrospective case-control study design was adopted...
July 19, 2016: Journal of Clinical Nursing
Adam Peña, Trevor Bibler
Mr. M is an eighty-five-year-old who presented to the hospital with congestive heart failure exacerbation, pneumonia, altered mental status, and sepsis. A physician determines that he lacks capacity, and the team in the intensive care unit looks to the patient's daughter, Celia, as his surrogate decision-maker because she is named as an agent in his medical power of attorney form. While in the ICU, Mr. M suffers acute respiratory distress secondary to pneumonia and thus requires intubation. Celia accepts several life-sustaining interventions, but she sporadically refuses other medically indicated therapies...
July 2016: Hastings Center Report
Kateřina Jiroutková, Adéla Krajčová, Jakub Žiak, Michal Fric, Jan Gojda, Valér Džupa, Martin Kalous, Jana Tůmová, Jan Trnka, František Duška
BACKGROUND: Functional mitochondria in skeletal muscle of patients with protracted critical illness and intensive care unit-acquired weakness are depleted, but remaining mitochondria have increased functional capacities of respiratory complexes II and III. This can be an adaptation to relative abundancy of fatty acid over glucose caused by insulin resistance. We hypothesized that the capacity of muscle mitochondria to oxidize fatty acid is increased in protracted critical illness. METHODS: We assessed fatty acid oxidation (FAO) and mitochondrial functional indices in vitro by using extracellular flux analysis in cultured myotubes obtained by isolating and culturing satellite cells from vastus lateralis muscle biopsy samples from patients with ICU-acquired weakness (n = 6) and age-matched healthy controls (n = 7)...
June 29, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Soichi Takeishi, Akihiro Mori, Hiroki Hachiya, Takayuki Yumura, Shun Ito, Takashi Shibuya, Shintaro Hayashi, Nobutoshi Fushimi, Noritsugu Ohashi, Hiromi Kawai
AIMS/INTRODUCTION: We aimed to identify factors - glycemic control, reactive inflammatory biomarkers or vital signs - associated with mortality in diabetic patients admitted to hospital for various infections (non-intensive care unit). MATERIALS AND METHODS: We retrospectively analyzed the cases of 620 diabetic patients admitted to hospital for various infections (non-intensive care unit) who underwent glucose monitoring >3 times per day. We extracted data regarding reactive inflammatory biomarkers and vital signs recorded on day 1 of hospital stay, and data on bacteremia and hypoglycemia status, glycemic variability (GV; coefficient of variation and standard deviation) and mean glucose concentrations during the entire hospital stay...
May 2016: Journal of Diabetes Investigation
Emily J McCleary, Sharla Tajchman
The safety of parenteral nutrition (PN) administration in critically ill patients has been the subject of much controversy. Historically, PN administration has been associated with an increased risk of bacterial and fungal infections, leading to significant morbidity and mortality. Much of the data showing increased infectious complications compared with either no nutrition or enteral nutrition was derived from early studies conducted in the 1980s-2000s. Poor glucose control and hyperalimentation are confounding factors in many early studies, making it difficult to determine the true PN infection risks...
August 2016: Nutrition in Clinical Practice
Palash Kar, Mark P Plummer, Rinaldo Bellomo, Alicia J Jenkins, Andrzej S Januszewski, Marianne J Chapman, Karen L Jones, Michael Horowitz, Adam M Deane
OBJECTIVES: The optimal blood glucose target in critically ill patients with preexisting diabetes and chronic hyperglycemia is unknown. In such patients, we aimed to determine whether a " liberal" approach to glycemic control would reduce hypoglycemia and glycemic variability and appear safe. DESIGN: Prospective, open-label, sequential-period exploratory study. SETTING: Medical-surgical ICU. PATIENTS: During sequential 6-month periods, we studied 83 patients with preexisting type 2 diabetes and chronic hyperglycemia (glycated hemoglobin, ≥ 7...
September 2016: Critical Care Medicine
P V Sai Saran, Shakti Bedanta Mishra, Pralay Shankar Ghosh, Afzal Azim
No abstract text is available yet for this article.
April 2016: Indian Journal of Critical Care Medicine
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"