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Hyperglycemia and ill critical patients

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https://www.readbyqxmd.com/read/28226967/nonlinear-model-predictive-glycemic-control-of-critically-ill-patients-using-online-identification-of-insulin-sensitivity
#1
Sha Wu, Eiko Furutani, Sha Wu, Eiko Furutani, Eiko Furutani, Sha Wu
In critically ill patients suffering from hyperglycemia, it has been recently shown that mortality and morbidity can be reduced by keeping blood glucose within the range of 80-110 mg/dL. However, maintaining glycemia within such range is difficult due to the time variability in insulin sensitivity in critically ill patients. In this paper, we propose a novel glycometabolism model of critically ill patients with an insulin sensitivity parameter and develop a nonlinear model predictive glycemic control system with online identification of insulin sensitivity at one-hour intervals...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28212470/-prediabetes-as-a-riskmarker-for-stress-induced-hyperglycemia-in-critically-ill-adults
#2
Diego Jesús García-Gallegos, Eliseo Luis-López
BACKGROUND: It is not known if patients with prediabetes, a subgroup of non-diabetic patients that usually present hyperinsulinemia, have higher risk to present stress-induced hyperglycemia. The objective was to determine if prediabetes is a risk marker to present stress-induced hyperglycemia. METHODS: Analytic, observational, prospective cohort study of non-diabetic critically ill patients of a third level hospital. We determined plasmatic glucose and glycated hemoglobin (HbA1c) at admission to diagnose stress-induced hyperglycemia (glucose ≥ 140 mg/dL) and prediabetes (HbA1c between 5...
2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28149085/complications-in-mechanically-ventilated-patients-of-guillain-barre-syndrome-and-their-prognostic-value
#3
Archana Becket Netto, Arun B Taly, Girish B Kulkarni, G S Uma Maheshwara Rao, Shivaji Rao
INTRODUCTION: The spectrum of various complications in critically ill Guillain-Barre syndrome (GBS) and its effect on the prognosis is lacking in literature. This study aimed at enumerating the complications in such a cohort and their significance in the prognosis and mortality. MATERIALS AND METHODS: Retrospective case record analysis of all consecutive mechanically ventilated patients of GBS in neurology Intensive Care Unit (ICU) of a tertiary care institute for 10 years was done...
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28118549/tight-glycemic-control-in-critically-ill-children
#4
Michael S D Agus, David Wypij, Eliotte L Hirshberg, Vijay Srinivasan, E Vincent Faustino, Peter M Luckett, Jamin L Alexander, Lisa A Asaro, Martha A Q Curley, Garry M Steil, Vinay M Nadkarni
Background In multicenter studies, tight glycemic control targeting a normal blood glucose level has not been shown to improve outcomes in critically ill adults or children after cardiac surgery. Studies involving critically ill children who have not undergone cardiac surgery are lacking. Methods In a 35-center trial, we randomly assigned critically ill children with confirmed hyperglycemia (excluding patients who had undergone cardiac surgery) to one of two ranges of glycemic control: 80 to 110 mg per deciliter (4...
February 23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28112704/evaluation-and-treatment-of-hyperglycemia-in-critically-ill-patients
#5
Andrea Balloni, Federico Lari, Fabrizio Giostra
The hyperglycemic reaction to stress is part of adaptive metabolic response to critical illness, especially hypoxia, hemorrhage and sepsis. It involves neuro-endocrine and immune pathways leading to the development of insulin resistance and hepatic glucose production by gluconeogenesis and glycogenolysis. Over the last years the concept of stress related hyperglycemia has been replaced by the concept of dysglycemia and its three domains: hyperglycemia, hypoglycemia and glycemic variability. Each of the three domains is independently associated with increased risk of mortality in patients admitted in intensive care unit and non critically ill patients, both medical and surgical...
January 16, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28067472/efficacy-of-basal-bolus-insulin-regimens-in-the-inpatient-management-of-non-critically-ill-patients-with-type-2-diabetes-a-systematic-review-and-meta-analysis
#6
REVIEW
Merete B Christensen, Anders Gotfredsen, Kirsten Nørgaard
BACKGROUND: Hyperglycemia during hospitalization is associated with increased rates of complications and longer hospital stays. Various insulin regimens are used in the inpatient diabetes management of non-critically ill patients. We aimed to assess the efficacy and safety of basal-bolus insulin therapy (BBI) by summarizing evidence from studies of BBI versus sliding scale insulin therapy (SSI) in the management of hospitalized non-critically ill type 2 diabetes patients. METHODS: We searched MEDLINE, EMBASE, Scopus and the Cochrane Library for studies comparing BBI therapy with SSI therapy in hospitalized non-critically ill patients with type 2 diabetes...
January 9, 2017: Diabetes/metabolism Research and Reviews
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
#7
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...
February 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28004329/validation-of-the-glycemic-stress-index-in-pediatric-neurosurgical-intensive-care
#8
Marco Piastra, Alessandro Pizza, Federica Tosi, Sonia Mensi, Luca Massimi, Andrea De Bellis, Daniele G Biasucci, Ersilia Luca, Giorgio Conti, Daniele De Luca
BACKGROUND: Studies have suggested that both the degree and the duration of hyperglycemia are independent risk factors for adverse outcome both in pediatric anesthesia and in critically ill children. In a recent paper, we combined intraoperative glycemic variations and length of surgery creating a metabolic glucose-related stress index called "Glycemic Stress Index" (GSI). AIM: To validate GSI for predicting PICU stay in a population of children undergoing different major neurosurgical procedures...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27998542/-metabolic-control-in-the-critically-ill-patient-an-update-hyperglycemia-glucose-variability-hypoglycemia-and-relative-hypoglycemia
#9
Ángel Augusto Pérez-Calatayud, Ariadna Guillén-Vidaña, Irving Santiago Fraire-Félix, Eduardo Daniel Anica-Malagón, Jesús Carlos Briones Garduño, Raúl Carrillo-Esper
BACKGROUND: Metabolic changes of glucose in critically ill patients increase morbidity and mortality. The appropriate level of blood glucose has not been established so far and should be adjusted for different populations. However concepts such as glucose variability and relative hypoglycemia of critically ill patients are concepts that are changing management methods and achieving closer monitoring. OBJECTIVES: The purpose of this review is to present new data about the management and metabolic control of patients in critical areas...
January 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27824941/establishment-and-validation-of-gv-saps-ii-scoring-system-for-non-diabetic-critically-ill-patients
#10
Wen-Yue Liu, Shi-Gang Lin, Gui-Qi Zhu, Sven Van Poucke, Martin Braddock, Zhongheng Zhang, Zhi Mao, Fei-Xia Shen, Ming-Hua Zheng
BACKGROUND AND AIMS: Recently, glucose variability (GV) has been reported as an independent risk factor for mortality in non-diabetic critically ill patients. However, GV is not incorporated in any severity scoring system for critically ill patients currently. The aim of this study was to establish and validate a modified Simplified Acute Physiology Score II scoring system (SAPS II), integrated with GV parameters and named GV-SAPS II, specifically for non-diabetic critically ill patients to predict short-term and long-term mortality...
2016: PloS One
https://www.readbyqxmd.com/read/27824898/stress-induced-hyperglycemia-and-the-subsequent-risk-of-type-2-diabetes-in-survivors-of-critical-illness
#11
Mark P Plummer, Mark E Finnis, Liza K Phillips, Palash Kar, Shailesh Bihari, Vishwanath Biradar, Stewart Moodie, Michael Horowitz, Jonathan E Shaw, Adam M Deane
OBJECTIVE: Stress induced hyperglycemia occurs in critically ill patients who have normal glucose tolerance following resolution of their acute illness. The objective was to evaluate the association between stress induced hyperglycemia and incident diabetes in survivors of critical illness. DESIGN: Retrospective cohort study. SETTING: All adult patients surviving admission to a public hospital intensive care unit (ICU) in South Australia between 2004 and 2011...
2016: PloS One
https://www.readbyqxmd.com/read/27788805/glucose-metabolism-and-associated-outcome-after-pediatric-liver-transplantation
#12
R Zant, M Melter, D Beck, M Ameres, B Knoppke, J Kunkel
BACKGROUND: Despite hypoglycemia and hyperglycemia being frequently observed in the early postoperative phase, information on glucose metabolism after pediatric liver transplantation (pLT) is scarce. METHODS: The goal of this retrospective single-center study, which included 46 patients who consecutively underwent 55 liver transplantations, was to gather data on glucose uptake, the prognostic relevance of hyperglycemia, and the safety of insulin administration in patients after pLT...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27788389/the-association-of-admission-blood-glucose-level-with-the-clinical-picture-and-prognosis-in-cardiogenic-shock-results-from-the-cardshock-study
#13
Anu Kataja, Tuukka Tarvasmäki, Johan Lassus, Jose Cardoso, Alexandre Mebazaa, Lars Køber, Alessandro Sionis, Jindrich Spinar, Valentina Carubelli, Marek Banaszewski, Rossella Marino, John Parissis, Markku S Nieminen, Veli-Pekka Harjola
BACKGROUND: Critically ill patients often present with hyperglycemia, regardless of previous history of diabetes mellitus (DM). Hyperglycemia has been associated with adverse outcome in acute myocardial infarction and acute heart failure. We investigated the association of admission blood glucose level with the clinical picture and short-term mortality in cardiogenic shock (CS). METHODS: Consecutively enrolled CS patients were divided into five categories according to plasma glucose level at the time of enrolment: hypoglycemia (glucose <4...
January 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27749341/association-between-perioperative-hyperglycemia-or-glucose-variability-and-postoperative-acute-kidney-injury-after-liver-transplantation-a-retrospective-observational-study
#14
Seokha Yoo, Ho-Jin Lee, Hannah Lee, Ho-Geol Ryu
BACKGROUND: Glucose control can be difficult in the intraoperative and immediate postoperative period of liver transplantation. Hyperglycemia and glucose variability have been associated with acute kidney injury (AKI) in critically ill patients. We performed a retrospective study to test the hypothesis that perioperative glucose levels represented by time-weighted average glucose levels and glucose variability are independently associated with the incidence of postoperative AKI in patients undergoing liver transplantation...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27736708/corticosteroids-and-neuromuscular-blockers-in-development-of-critical-illness-neuromuscular-abnormalities-a-historical-review
#15
REVIEW
Susan R Wilcox
Weakness is common in critically ill patients, associated with prolonged mechanical ventilation and increased mortality. Corticosteroids and neuromuscular blockade (NMB) administration have been implicated as etiologies of acquired weakness in the intensive care unit. Medical literature since the 1970s is replete with case reports and small case series of patients with weakness after receiving high-dose corticosteroids, prolonged NMB, or both. Several risk factors for weakness appear in the early literature, including large doses of steroids, the dose and duration of NMB, hyperglycemia, and the duration of mechanical ventilation...
February 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27648697/interleukin-18-reduces-blood-glucose-and-modulates-plasma-corticosterone-in-a-septic-mouse-model
#16
Hayato Yamashita, Michiko Ishikawa, Taketo Inoue, Makoto Usami, Yu Usami, Joji Kotani
BACKGROUND: Dysregulation of glucose metabolism, including hyperglycemia with insulin resistance, is commonly observed in critically ill patients. Interleukin-18 (IL-18) improves the insulin resistance associated with obesity, but the relationship between IL-18 and glucose metabolism in sepsis was unclear. The purpose of this study was to investigate the influence of IL-18 on hyperglycemia during sepsis. METHODS: Sepsis was induced using cecal ligation and puncture (CLP) in wild type (WT) mice, IL-18 knockout (KO) mice, and IL-18 KO mice pretreated with recombinant IL-18...
September 19, 2016: Shock
https://www.readbyqxmd.com/read/27645817/critical-care-glucose-point-of-care-testing
#17
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
#18
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
#19
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
https://www.readbyqxmd.com/read/27490613/endocrinologic-diseases-in-pediatric-cardiac-intensive-care
#20
Carmen L Soto-Rivera, Steven M Schwartz, Jaclyn E Sawyer, Duncan J Macrae, Michael S D Agus
OBJECTIVES: The objectives of this review are to discuss the pathophysiology, clinical impact and treatment of hyperglycemia, and disturbances in thyroid and adrenal function prior to and following cardiac surgery in children. DATA SOURCE: MEDLINE and PubMed. CONCLUSIONS: Disturbances in glucose metabolism and thyroid and adrenal function are common in critically ill children with cardiac disease and in particular in children undergoing cardiac surgery for complex congenital heart disease...
August 2016: Pediatric Critical Care Medicine
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