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glucose control in icu

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https://www.readbyqxmd.com/read/29776872/oral-glucose-and-listening-to-lullaby-to-decrease-pain-in-preterm-infants-supported-with-ncpap-a-randomized-controlled-trial
#1
Kadir Şerafettin Tekgündüz, Sevinç Polat, Ayşe Gürol, Serap Ejder Apay
Preterm infants spend the early days of their lives in neonatal intensive care units, where they undergo many minor painful procedures. There are many nonpharmacologic methods that can effectively reduce the pain response of neonates who undergo routine procedures. This study aimed to investigate whether oral glucose and listening to lullabies could bring pain relief during the removal and reinsertion of the tracheal tube and also oronasopharyngeal suctioning in premature infants to whom nasal continuous positive airway pressure was applied...
May 15, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29762485/stress-induced-and-diabetic-hyperglycemia-associated-with-higher-mortality-among-intensive-care-unit-trauma-patients-cross-sectional-analysis-of-the-propensity-score-matched-population
#2
Meng-Wei Chang, Chun-Ying Huang, Hang-Tsung Liu, Yi-Chun Chen, Ching-Hua Hsieh
BACKGROUND: This study was designed to measure the effect of stress-induced hyperglycemia (SIH) and diabetic hyperglycemia (DH) versus non-diabetic normoglycemia (NDN) on the outcomes of trauma patients in the intensive care unit (ICU). METHODS: Diabetes mellitus (DM) was determined based on patient history and/or a hemoglobin A1c (HbA1c) level of ≥6.5% at admission. The patients who had serum glucose levels of ≥200 mg/dL in the absence or presence of DM were assigned into the groups SIH and DH, respectively...
May 15, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29760928/aneurysmal-subarachnoid-hemorrhage-intensive-care-for-improving-neurological-outcome
#3
REVIEW
Tomoya Okazaki, Yasuhiro Kuroda
Background: Aneurysmal subarachnoid hemorrhage is a life-threatening disease requiring neurocritical care. Delayed cerebral ischemia is a well-known complication that contributes to unfavorable neurological outcomes. Cerebral vasospasm has been thought to be the main cause of delayed cerebral ischemia, and although several studies were able to decrease cerebral vasospasm, none showed improved neurological outcomes. Our target is not cerebral vasospasm but improving neurological outcomes...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29757412/development-of-a-provincial-initiative-to-improve-glucose-control-in-critically-ill-patients
#4
Peter Dodek, Shari McKeown, Eric Young, Vinay Dhingra
Objective: To describe the development, implementation and initial evaluation of an initiative to improve glucose control in critically ill patients. Design: Glucose control in critically ill patients was chosen by critical care leaders as a target for improvement. This was an observational study to document changes in processes and measures of glucose control in each intensive care unit (ICU). ICU nurse educators were interviewed to document relevant changes between April 2012 and April 2016...
May 11, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29731716/protective-effect-of-casperome-%C3%A2-an-orally-bioavailable-frankincense-extract-on-lipopolysaccharide-induced-systemic-inflammation-in-mice
#5
Konstantin Loeser, Semjon Seemann, Stefanie König, Isabell Lenhardt, Mona Abdel-Tawab, Andreas Koeberle, Oliver Werz, Amelie Lupp
Introduction: Despite recent advances in critical care, sepsis remains a crucial cause of morbidity and mortality in intensive care units. Therefore, the identification of new therapeutic strategies is of great importance. Since ancient times, frankincense is used in traditional medicine for the treatment of chronic inflammatory disorders such as rheumatoid arthritis. Thus, the present study intends to evaluate if Casperome® (Casp), an orally bioavailable soy lecithin-based formulation of standardized frankincense extract, is able to ameliorate systemic effects and organ damages induced by severe systemic inflammation using a murine model of sepsis, i...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29727367/insidious-harm-of-medication-diluents-as-a-contributor-to-cumulative-volume-and-hyperchloremia-a-prospective-open-label-sequential-period-pilot-study
#6
Carolyn A Magee, Melissa L Thompson Bastin, Melanie E Laine, Brittany D Bissell, Gavin T Howington, Peter R Moran, Emily J McCleary, Gary D Owen, Lauren E Kane, Emily A Higdon, Cathy A Pierce, Peter E Morris, Alexander H Flannery
OBJECTIVES: Although the potential dangers of hyperchloremia from resuscitation fluids continue to emerge, no study to date has considered the contribution of medication diluents to cumulative volume and hyperchloremia. This study compares saline versus dextrose 5% in water as the primary medication diluent and the occurrence of hyperchloremia in critically ill patients. DESIGN: Prospective, open-label, sequential period pilot study. SETTING: Medical ICU of a large academic medical center...
May 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29705217/lower-glucose-target-is-associated-with-improved-30-day-mortality-in-cardiac-and-cardiothoracic-patients
#7
Andrew M Hersh, Eliotte L Hirshberg, Emily L Wilson, James F Orme, Alan H Morris, Michael J Lanspa
BACKGROUND: Practice guidelines recommend against Intensive Insulin Therapy (IIT) in critically ill patients based on trials that had high rates of severe hypoglycemia. Intermountain Healthcare uses a computerized intravenous insulin protocol (eProtocol-insulin) that allows choice of blood glucose (BG) targets (80-110 mg/dl versus 90-140 mg/dl), and has low rates of severe hypoglycemia. We sought to study the effects of BG target on mortality in adult patients in cardiac intensive care units (ICUs) that have very low rates of severe hypoglycemia...
April 26, 2018: Chest
https://www.readbyqxmd.com/read/29683136/continuous-glucose-monitoring-in-the-cardiac-icu-current-use-and-future-directions
#8
Laura A Scrimgeour, Brittany A Potz, Frank W Sellke, M Ruhul Abid
Perioperative glucose control is highly important, particularly for patients undergoing cardiac surgery. Variable glucose levels before, during and after cardiac surgery lead to increased post-operative complications and patient mortality. [1] Current methods for intensive monitoring and treating hyperglycemia in the Intensive Care Unit (ICU) usually involve hourly glucose monitoring and continuous intravenous insulin infusions. With the advent of more accurate subcutaneous glucose monitoring systems, the role of improved glucose control with newer systems deserves consideration for widespread adoption...
November 2017: Clinical medicine research
https://www.readbyqxmd.com/read/29678711/healthcare-associated-infections-after-subarachnoid-hemorrhage
#9
Yasser B Abulhasan, Najayeb Alabdulraheem, Ian Schiller, Susan P Rachel, Nandini Dendukuri, Mark R Angle, Charles Frenette
OBJECTIVE: Healthcare-associated infections (HAIs) after subarachnoid hemorrhage (SAH) are prevalent; however, data describing epidemiology of infection is limited. This study reports incidence rates, risk factors and the resulting SAH patient-related outcomes. METHODS: We studied the incidence of ICU-acquired HAIs over a 6-year period. We used Bayesian Model Averaging to identify risk factors associated with an increased risk of HAIs, particularly urinary tract infections (UTI), pneumonia and ventriculostomy-associated infections (VAI)...
April 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29677007/near-continuous-glucose-monitoring-makes-glycemic-control-safer-in-icu-patients
#10
Jean-Charles Preiser, Olivier Lheureux, Aurelie Thooft, Serge Brimioulle, Jacques Goldstein, Jean-Louis Vincent
OBJECTIVES: Tight glycemic control using intermittent blood glucose measurements is associated with a risk of hypoglycemia. Glucose concentrations can now be measured near continuously (every 5-15 min). We assessed the quality and safety of glycemic control guided by a near-continuous glucose monitoring system in ICU patients. DESIGN: Prospective, cluster-randomized, crossover study. SETTING: Thirty-five-bed medico-surgical department of intensive care with four separate ICUs...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29657375/comparison-of-glycemic-control-between-continuous-regular-insulin-infusion-and-single-dose-subcutaneous-insulin-glargine-injection-in-medical-critically-ill-patients
#11
Rungsun Bhurayanontachai, Tharittamon Rattanaprapat, Chanon Kongkamol
Background and Aims: This study aimed to compare glycemic control between continuous intravenous regular insulin infusion and single-dose subcutaneous insulin glargine injection in medical critically ill patients. Subjects and Methods: A prospective noninferiority study was conducted in medical critically ill patients who developed hyperglycemia and required regular insulin infusion by the Intensive Care Unit glycemic control protocol. The eligible patients were switched from the daily regular insulin requirement to single-dose subcutaneous insulin glargine injection by a 100% conversion dose...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29652278/effects-of-glargine-insulin-on-glycemic-control-in-patients-with-diabetes-mellitus-type-ii-undergoing-off-pump-coronary-artery-bypass-graft
#12
Hemang Gandhi, Alpesh Sarvaia, Amber Malhotra, Himanshu Acharya, Komal Shah, Jeevraj Rajavat
Background: The prevalence of diabetes mellitus in patients requiring coronary artery bypass grafting (CABG) is noticeably high (20%-30%). These patients have inferior perioperative outcome, reduced long-term survival, and high risk of recurrent episodes of angina. To improve perioperative outcome surgical unit defined satisfactory glycemic control is desired during this period. Hence, the aim of our study is to compare the efficacy of glargine insulin combination with continuous human insulin infusion for perioperative glycemic control in patients with diabetes undergoing CABG...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29650049/variation-in-general-supportive-and-preventive-intensive-care-management-of-traumatic-brain-injury-a-survey-in-66-neurotrauma-centers-participating-in-the-collaborative-european-neurotrauma-effectiveness-research-in-traumatic-brain-injury-center-tbi-study
#13
Jilske A Huijben, Victor Volovici, Maryse C Cnossen, Iain K Haitsma, Nino Stocchetti, Andrew I R Maas, David K Menon, Ari Ercole, Giuseppe Citerio, David Nelson, Suzanne Polinder, Ewout W Steyerberg, Hester F Lingsma, Mathieu van der Jagt
BACKGROUND: General supportive and preventive measures in the intensive care management of traumatic brain injury (TBI) aim to prevent or limit secondary brain injury and optimize recovery. The aim of this survey was to assess and quantify variation in perceptions on intensive care unit (ICU) management of patients with TBI in European neurotrauma centers. METHODS: We performed a survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study...
April 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29605395/prophylactic-dextrose-gel-does-not-prevent-neonatal-hypoglycemia-a-quasi-experimental-pilot-study
#14
Sarah M Coors, Joshua J Cousin, Joseph L Hagan, Jeffrey R Kaiser
OBJECTIVE: To test the hypothesis that prophylactic dextrose gel administered to newborn infants at risk for hypoglycemia will increase the initial blood glucose concentration after the first feeding and decrease neonatal intensive care unit (NICU) admissions for treatment of asymptomatic neonatal hypoglycemia compared with feedings alone. STUDY DESIGN: This quasi-experimental study allocated asymptomatic at-risk newborn infants (late preterm, birth weight <2500 or >4000 g, and infants of mothers with diabetes) to receive prophylactic dextrose gel (Insta-Glucose; Valeant Pharmaceuticals North America LLC, Bridgewater, New Jersey); other at-risk infants formed the control group...
March 28, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29604150/neurophysiological-study-of-critical-illness-polyneuropathy-and-myopathy-in-mechanically-ventilated-children-additional-aspect-into-pediatric-critical-illness-comorbidities
#15
Ahmed Thabet Mahmoud, Maha A M Tawfik, Sameh Abdallah Abd El Naby, Wafaa Moustafa M Abo El Fotoh, Nagwan Yossery Saleh, Nahla M Said Abd El Hady
BACKGROUND: Critical illness polyneuropathy and myopathy (CIP/CIM) is being increasingly recognized as a significant clinical problem in critically ill children especially who have spent long periods in the intensive care unit. So we aimed to determine the frequency of CIP/CIM among mechanically ventilated children and to analyze the associated risk factors and drawbacks frequently encountered in this cohort. METHODS: The study included 105 patients admitted to the pediatric intensive care unit and underwent mechanical ventilation for ≥7 days...
March 31, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29579844/postoperative-care-in-kidney-transplantation-a-comparison-between-controlled-and-uncontrolled-donation-after-circulatory-death
#16
Á J Roldán-Reina, J J Egea-Guerrero, N Palomo-López, D X Cuenca-Apolo, M Adriaensens-Pérez, M Porras-López, Z Ruiz de Azúa-López, Y Corcia-Palomo, L Martín-Villén
Recent research in kidney transplantation has revealed differences in the evolution of renal function among patients transplanted from 2 alternative programs for donation after circulatory death (DCD). A retrospective, observational, single-center study was carried out from 2013 to 2016 at a level III hospital intensive care unit (ICU) to assess the progression of kidney recipients after transplants from uncontrolled DCD (uDCD) or controlled DCD (cDCD). The following variables were collected for data analysis: demographics, comorbidities, type of donation, lactate, hemoglobin and glucose levels at ICU admission, creatinine concentration at ICU admission, at-hospital ward transfer, at-hospital discharge, radioisotope imaging results, ICU and in-hospital length of stay, and mortality...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29519778/outcome-of-critically-ill-patients-undergoing-mandatory-insulin-therapy-compared-to-usual-care-insulin-therapy-protocol-for-a-pilot-randomized-controlled-trial
#17
Peter J Watkinson, Vicki S Barber, J Duncan Young
BACKGROUND: Observational and interventional studies in patients with both acute medical conditions and long-standing diabetes have shown that improved blood glucose control confers a survival advantage or reduces complication rates. Policies of "tight" glycaemic control were rapidly adopted by many general intensive care units (ICUs) worldwide in the mid 00's, even though the results of the studies were not generalizable to mixed medical/surgical ICUs with different intravenous feeding policies...
March 8, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29509570/liberal-glucose-control-in-icu-patients-with-diabetes-a-before-and-after-study
#18
Nora Luethi, Luca Cioccari, Peter Biesenbach, Luca Lucchetta, Hidetoshi Kagaya, Rhys Morgan, Francesca Di Muzio, Barbara Presello, Duaa Gaafar, Alison Hay, Marco Crisman, Roisin Toohey, Hollie Russell, Neil J Glassford, Glenn M Eastwood, Elif I Ekinci, Adam M Deane, Rinaldo Bellomo, Johan Mårtensson
OBJECTIVES: To assess the feasibility, biochemical efficacy, and safety of liberal versus conventional glucose control in ICU patients with diabetes. DESIGN: Prospective, open-label, sequential period study. SETTING: A 22-bed mixed ICU of a tertiary hospital in Australia. PATIENTS: We compared 350 consecutive patients with diabetes admitted over 15 months who received liberal glucose control with a preintervention control population of 350 consecutive patients with diabetes who received conventional glucose control...
June 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29501063/tight-glycemic-control-in-critically-ill-pediatric-patients-a-systematic-review-and-meta-analysis
#19
Lvlin Chen, Tiangui Li, Fang Fang, Yu Zhang, Andrew Faramand
BACKGROUND: Hyperglycemia is prevalent in patients in the pediatric intensive care unit. The purpose of this study was to describe the benefits and risks of tight glucose control (TGC) in critically ill children. METHODS: A systemic review and meta-analysis of the literature was carried out on randomized controlled trials of TGC in critically ill children admitted to the pediatric intensive care unit. The databases searched were Medline, Embase, and CENTRAL databases until May 1, 2017...
March 4, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29458699/continuous-positive-airway-pressure-therapy-in-gestational-diabetes-with-obstructive-sleep-apnea-a-randomized-controlled-trial
#20
Naricha Chirakalwasan, Somvang Amnakkittikul, Ekasitt Wanitcharoenkul, Suranut Charoensri, Sunee Saetung, Suwannee Chanprasertyothin, La-Or Chailurkit, Panyu Panburana, Sommart Bumrungphuet, Ammarin Thakkinstian, Sirimon Reutrakul
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is associated with gestational diabetes mellitus (GDM). This study assessed the effects of continuous positive airway pressure (CPAP) in obese pregnant females with GDM and OSA. METHODS: A randomized controlled trial was conducted (April 2014 - June 2016). Obese females at 24 to 34 weeks gestation and with diet-controlled GDM were screened for OSA. Those with OSA were randomly assigned to receive 2 weeks nightly CPAP or be part of a waitlist control group...
March 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
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