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glucose control in icu

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https://www.readbyqxmd.com/read/28072822/point-of-care-versus-central-laboratory-measurements-of-hemoglobin-hematocrit-glucose-bicarbonate-and-electrolytes-a-prospective-observational-study-in-critically-ill-patients
#1
Jérôme Allardet-Servent, Melissa Lebsir, Christian Dubroca, Martine Fabrigoule, Sylvie Jordana, Thomas Signouret, Matthias Castanier, Guillemette Thomas, Rettinavelou Soundaravelou, Anne Lepidi, Laurence Delapierre, Guillaume Penaranda, Philippe Halfon, Jean-Marie Seghboyan
INTRODUCTION: Rapid detection of abnormal biological values using point-of-care (POC) testing allows clinicians to promptly initiate therapy; however, there are concerns regarding the reliability of POC measurements. We investigated the agreement between the latest generation blood gas analyzer and central laboratory measurements of electrolytes, bicarbonate, hemoglobin, hematocrit, and glucose. METHODS: 314 paired samples were collected prospectively from 51 critically ill patients...
2017: PloS One
https://www.readbyqxmd.com/read/28063297/higher-glucose-variability-in-type-1-than-in-type-2-diabetes-patients-admitted-to-the-intensive-care-unit-a-retrospective-cohort-study
#2
Marjolein K Sechterberger, Sigrid C J van Steen, Esther M N Boerboom, Peter H J van der Voort, Rob J Bosman, Joost B L Hoekstra, J Hans DeVries
PURPOSE: Although the course of disease of type 1 and type 2 diabetes differs, the distinction is rarely made when patients are admitted to the intensive care unit (ICU). Here, we report patient- and admission-related characteristics in relation to glycemic measures of patients with type 1 and type 2 diabetes admitted to the ICU. MATERIALS AND METHODS: A retrospective chart review was performed of 1574 patients with diabetes admitted between 2004 and 2011 to our ICU...
December 29, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28042054/design-and-rationale-of-heart-and-lung-failure-pediatric-insulin-titration-trial-half-pint-a-randomized-clinical-trial-of-tight-glycemic-control-in-hyperglycemic-critically-ill-children
#3
Michael Sd Agus, Ellie Hirshberg, Vijay Srinivasan, Edward Vincent Faustino, Peter M Luckett, Martha Aq Curley, Jamin Alexander, Lisa A Asaro, Kerry Coughlin-Wells, Donna Duva, Jaclyn French, Natalie Hasbani, Martha T Sisko, Carmen L Soto-Rivera, Garry Steil, David Wypij, Vinay M Nadkarni
OBJECTIVES: Test whether hyperglycemic critically ill children with cardiovascular and/or respiratory failure experience more ICU-free days when assigned to tight glycemic control with a normoglycemic versus hyperglycemic blood glucose target range. DESIGN: Multi-center randomized clinical trial. SETTING: Pediatric ICUs at 35 academic hospitals. PATIENTS: Children aged 2weeks to 17years receiving inotropic support and/or acute mechanical ventilation, excluding cardiac surgical patients...
December 30, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27974972/acute-kidney-injury-in-diabetes-mellitus
#4
REVIEW
D Patschan, G A Müller
Diabetes mellitus (DM) significantly increases the overall morbidity and mortality, particularly by elevating the cardiovascular risk. The kidneys are severely affected as well, partly as a result of intrarenal athero- and arteriosclerosis but also due to noninflammatory glomerular damage (diabetic nephropathy). DM is the most frequent cause of end-stage renal disease in our society. Acute kidney injury (AKI) remains a clinical and prognostic problem of fundamental importance since incidences have been increased in recent years while mortality has not substantially been improved...
2016: International Journal of Nephrology
https://www.readbyqxmd.com/read/27969048/oral-glucose-efficacy-on-neonate-s-pain-responses-at-the-nicu-a-quasi-experimental-trial-of-two-clinical-procedures
#5
Eman M Matar, Diana H Arabiat, Mandie J Foster
AIM: This research was undertaken with the purpose of testing two research hypotheses regarding the efficacy of 10% oral glucose solution on procedural pain associated with venepuncture and nasopharyngeal suctioning within three neonatal intensive care units (NICU). The hypotheses were formulated from previous conclusions reached by other researchers highlighting the efficacy of sucrose solutions on neonates' pain responses during minor painful procedures. METHOD: A quasi-experimental trial utilising a time series design with one group was used...
November 2016: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/27967228/safety-and-efficacy-of-personalized-glycemic-control-in-critically-ill-patients-a-2-year-before-and-after-interventional-trial
#6
James S Krinsley, Jean-Charles Preiser, Irl B Hirsch
Objective To determine the safety and efficacy of a change in blood glucose (BG) control protocol from a single target to 2 targets based on diabetes status and glycated hemoglobin (A1C) in a cohort of critically ill patients. Methods This investigation includes 1,979 patients admitted to a single intensive care unit between September 16, 2013 and September 15, 2015. The BG target was 90-120 mg/dL in the PRE era and 80-140 mg/dL for patients without diabetes (NON) and diabetes patients (DM) with A1C < 7% and 110-160 mg/dL for DM with A1C > 7% (TIGHT and LOOSE protocols) in the POST era...
December 14, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27965877/survivors-of-intensive-care-with-type-2-diabetes-and-the-effect-of-shared-care-follow-up-clinics-study-protocol-for-the-sweet-as-randomised-controlled-feasibility-study
#7
Yasmine Ali Abdelhamid, Liza Phillips, Michael Horowitz, Adam Deane
BACKGROUND: Many patients who survive the intensive care unit (ICU) experience long-term complications such as peripheral neuropathy and nephropathy which represent a major source of morbidity and affect quality of life adversely. Similar pathophysiological processes occur frequently in ambulant patients with diabetes mellitus who have never been critically ill. Some 25 % of all adult ICU patients have diabetes, and it is plausible that ICU survivors with co-existing diabetes are at heightened risk of sequelae from their critical illness...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27959419/antimicrobial-resistance-development-following-surgical-site-infections
#8
Daniela Călina, Anca Oana Docea, Lucica Rosu, Ovidiu Zlatian, Alexandra Floriana Rosu, Florin Anghelina, Otilia Rogoveanu, Andreea Letiția Arsene, Alina Crenguța Nicolae, Cristina Manuela Drăgoi, John Tsiaoussis, Aristides M Tsatsakis, Demetrios A Spandidos, Nikolaos Drakoulis, Eliza Gofita
Surgical site infections (SSIs) determine an increase in hospitalization time and antibiotic therapy costs. The aim of this study was to identify the germs involved in SSIs in patients from the Clinical Emergency County Hospital of Craiova (SCJUC) and to assess their resistance to antimicrobials, with comparisons between surgical wards and the intensive care unit (ICU). The biological samples were subjected to classical bacteriological diagnostics. Antibiotic resistance was tested by disc diffusion. We used hierarchical clustering as a method to group the isolates based upon the antibiotic resistance profile...
February 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27884157/manual-versus-automated-monitoring-accuracy-of-glucose-ii-manage-ii
#9
Cláudia Righy Shinotsuka, Alexandre Brasseur, David Fagnoul, Timothy So, Jean-Louis Vincent, Jean-Charles Preiser
BACKGROUND: Intravascular continuous glucose monitoring (CGM) may facilitate glycemic control in the intensive care unit (ICU). We compared the accuracy of a CGM device (OptiScanner®) with a standard reference method. METHODS: Adult patients who had blood glucose (BG) levels >150 mg/dl and required insertion of an arterial and central venous catheter were included. The OptiScanner® was inserted into a multiple-lumen central venous catheter. Patients were treated using a dynamic-scale insulin algorithm to achieve BG values between 80 and 150 mg/dl...
November 25, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27878572/a-comparison-of-two-insulin-infusion-protocols-in-the-medical-intensive-care-unit-by-continuous-glucose-monitoring
#10
Christophe E M De Block, Peter Rogiers, Philippe G Jorens, Tom Schepens, Cosimo Scuffi, Luc F Van Gaal
BACKGROUND: Achieving good glycemic control in intensive care units (ICU) requires a safe and efficient insulin infusion protocol (IIP). We aimed to compare the clinical performance of two IIPs (Leuven versus modified Yale protocol) in patients admitted to medical ICU, by using continuous glucose monitoring (CGM). This is a pooled data analysis of two published prospective randomized controlled trials. CGM monitoring was performed in 57 MICU patients (age 64 ± 12 years, APACHE-II score 28 ± 7, non-diabetic/diabetic: 36/21)...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27876693/a-case-of-septic-shock-due-to-serratia-marcescens-pyelonephritis-and-bacteremia-in-a-patient-receiving-empagliflozin
#11
Wesley D Kufel, Ali Scrimenti, Jeffrey M Steele
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been associated with serious urinary tract infections (UTIs) including pyelonephritis and urosepsis. The Food and Drug Administration (FDA) issued a label change to include this warning in December 2015 due to a small number of cases (n = 19) reported to the FDA Adverse Event Reporting System. Details of these cases are limited and none involved empagliflozin. To date, there has been no published literature comprehensively describing serious UTIs attributed to empagliflozin...
November 21, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27821581/association-between-the-use-of-long-acting-insulin-and-hypoglycemia-in-nondiabetic-patients-in-the-surgical-intensive-care-unit
#12
Jordan Masse, Christopher Alan Giuliano, Sara Brown, Renee Alexander Paxton
PURPOSE: The purpose of this study was to examine the association between long-acting insulin and hypoglycemia in nondiabetic surgical intensive care patients. METHODS: This single-center, retrospective cohort study evaluated glycemic control in nondiabetic critically ill surgical patients receiving long-acting insulin plus sliding scale versus those receiving sliding scale alone. Patients were matched based on sliding scale order and type of surgery. The primary outcome was the proportion of patients who experienced hypoglycemia (glucose values <70 mg/dL)...
November 7, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27761451/glucose-management-in-the-intensive-care-unit-are-we-looking-for-the-right-sweet-spot
#13
COMMENT
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
https://www.readbyqxmd.com/read/27757740/design-and-%C3%AE-testing-of-an-electronic-rounding-tool-certainp-to-improve-process-of-care-in-pediatric-intensive-care-unit
#14
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
https://www.readbyqxmd.com/read/27735930/prenatal-visit-utilization-and-outcomes-in-pregnant-women-with-type-ii-and-gestational-diabetes
#15
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
https://www.readbyqxmd.com/read/27699071/a-rare-case-of-persistent-lactic-acidosis-in-the-icu-glycogenic-hepatopathy-and-mauriac-syndrome
#16
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
https://www.readbyqxmd.com/read/27676715/bladder-rupture-secondary-to-emphysematous-bladder-a-diabetic-patient-report
#17
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
https://www.readbyqxmd.com/read/27645817/critical-care-glucose-point-of-care-testing
#18
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
https://www.readbyqxmd.com/read/27637719/glycemic-control-mortality-and-hypoglycemia-in-critically-ill-patients-a-systematic-review-and-network-meta-analysis-of-randomized-controlled-trials
#19
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...
January 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/27633987/prevalence-of-ketosis-ketonuria-and-ketoacidosis-during-liberal-glycemic-control-in-critically-ill-patients-with-diabetes-an-observational-study
#20
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...
September 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
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