keyword
MENU ▼
Read by QxMD icon Read
search

Hyperglycemia and ill critical patients

keyword
https://www.readbyqxmd.com/read/29044305/dysglycemia-in-the-critically-ill-patient-current-evidence-and-future-perspectives
#1
Ignacio Aramendi, Gastón Burghi, William Manzanares
Dysglycemia in critically ill patients (hyperglycemia, hypoglycemia, glycemic variability and time in range) is a biomarker of disease severity and is associated with higher mortality. However, this impact appears to be weakened in patients with previous diabetes mellitus, particularly in those with poor premorbid glycemic control; this phenomenon has been called "diabetes paradox". This phenomenon determines that glycated hemoglobin (HbA1c) values should be considered in choosing glycemic control protocols on admission to an intensive care unit and that patients' target blood glucose ranges should be adjusted according to their HbA1c values...
July 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29038248/lipopolysaccharide-potentiates-insulin-driven-hypoglycemic-shock
#2
Jon A Hagar, Matthew L Edin, Fred B Lih, Lance R Thurlow, Beverly H Koller, Bruce A Cairns, Darryl C Zeldin, Edward A Miao
Critically ill patients typically present with hyperglycemia. Treatment with conventional insulin therapy (targeting 144-180 mg/dl) improves patient survival; however, intensive insulin therapy (IIT) targeting normal blood glucose levels (81-108 mg/dl) increases the incidence of moderate and severe hypoglycemia, and increases mortality. Septic patients are especially prone to IIT-induced hypoglycemia, but the mechanism remains unknown. Here, we show that codelivery of insulin with otherwise sublethal doses of LPS induced hypoglycemic shock in mice within 1-2 h...
October 16, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28994678/evaluation-of-the-effect-of-metformin-and-insulin-in-hyperglycemia-treatment-after-coronary-artery-bypass-surgery-in-nondiabetic-patients
#3
Kamran Ghods, Hossein Davari, Abbasali Ebrahimian
INTRODUCTION: Insulin therapy is the most commonly used treatment for controlling hyperglycemia after coronary artery bypass surgery in both diabetic and nondiabetic patients. Metformin has been indicated for critically ill patients as an alternate for the treatment of hyperglycemia. This study evaluated the effect of metformin and insulin in hyperglycemia treatment after coronary artery bypass surgery in nondiabetic patients. SETTINGS AND DESIGN: This study was a clinical trial comprising nondiabetic patients who had undergone coronary artery bypass surgery...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28935429/glycemic-control-in-patients-undergoing-coronary-artery-bypass-graft-surgery-clinical-features-predictors-and-outcomes
#4
Judson B Williams, Eric D Peterson, Álvaro S Albrecht, Shuang Li, Sameer A Hirji, T Ferguson, Peter K Smith, Renato D Lopes
PURPOSE: Critically ill patients with hyperglycemia have worse prognosis. The degree to which glycemic control is achieved following CABG surgery and the association with clinical outcomes is not well understood. MATERIALS AND METHODS: We studied patients undergoing higher risk CABG surgery at 55 US hospitals. Good glycemic control was defined as 70-180mg/dL in the first 24h postoperatively. Generalized estimating equations logistic regression models were used to assess the relationship between glycemic control and clinical outcomes after adjusting for baseline characteristics...
September 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28926994/the-metabolic-response-to-stress-and-infection-in-critically-ill-children-the-opportunity-of-an-individualized-approach
#5
REVIEW
Valentina De Cosmi, Gregorio Paolo Milani, Alessandra Mazzocchi, Veronica D'Oria, Marco Silano, Edoardo Calderini, Carlo Agostoni
The metabolic response to stress and infection is closely related to the corresponding requirements of energy and nutrients. On a general level, the response is driven by a complex endocrine network and related to the nature and severity of the insult. On an individual level, the effects of nutritional interventions are highly variable and a possible source of complications. This narrative review aims to discuss the metabolic changes in critically-ill children and the potential of developing personalized nutritional interventions...
September 18, 2017: Nutrients
https://www.readbyqxmd.com/read/28904479/effect-of-fat-based-versus-carbohydrate-based-enteral-feeding-on-glycemic-control-in-critically-ill-patients-a-randomized-clinical-trial
#6
Mahdieh Nourmohammadi, Omid Moradi Moghadam, Mohammad Niakan Lahiji, Sevak Hatamian, Zahra Vahdat Shariatpanahi
BACKGROUND AND AIMS: The aim of this study was to evaluate the preventive effects of high-fat enteral feeding on glycemic control and clinical outcomes in critically ill patients: a randomized clinical trial. MATERIALS AND METHODS: This study was done on 42 normoglycemic patients admitted to Intensive Care Unit (ICU). Patients were randomly classified into three groups of 14 each. Control group (A) received carbohydrate-based diet (protein: 20%, fat: 30%, and carbohydrate: 50%), study groups received two types of high-fat diet; Group B (protein: 20%, fat: 45% including half of olive oil and half sunflower oil, and carbohydrate: 35%); and Group C (protein: 20%, fat: 45% including sunflower oil, and carbohydrate: 35%) in the first 48 h of admission...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28875724/the-long-and-winding-road-toward-personalized-glycemic-control-in-the-critically-ill
#7
James Stephen Krinsley
Hyperglycemia is very common in critically ill patients and interventional studies of intensive insulin therapy with the goal of returning ICU glycemia to normal levels have demonstrated mixed results. A large body of literature has demonstrated that diabetes, per se, is not independently associated with increased risk of mortality in this population and that the relationship of glucose metrics to mortality is different for patients with and without diabetes. Moreover, these relationships are confounded by preadmission glycemia; in this regard, patients with diabetes and good preadmission glucose control, as reflected by HbA1c levels obtained at the time of ICU admission, are similar to patients without diabetes...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28866977/intensity-of-early-correction-of-hyperglycaemia-and-outcome-of-critically-ill-patients-with-diabetic-ketoacidosis
#8
Johan Mårtensson, Michael Bailey, Balasubramanian Venkatesh, David Pilcher, Adam Deane, Yasmine Ali Abdelhamid, Marco Crisman, Brij Verma, Christopher MacIsaac, Geoffrey Wigmore, Yahya Shehabi, Takafumi Suzuki, Craig French, Neil Orford, Nima Kakho, Johannes Prins, Elif I Ekinci, Rinaldo Bellomo
OBJECTIVES: To determine the impact of the intensity of early correction of hyperglycaemia on outcomes in patients with diabetic ketoacidosis (DKA) admitted to the intensive care unit. METHODS: We studied adult patients with DKA admitted to 171 ICUs in Australia and New Zealand from 2000 to 2013. We used their blood glucose levels (BGLs) in the first 24 hours after ICU admission to determine whether intensive early correction of hyperglycemia to ≤ 180 mg/dL was independently associated with hypoglycaemia, hypokalaemia, hypo-osmolarity or mortality, compared with partial early correction to > 180 mg/dL as recommended by DKA-specific guidelines...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28836546/comparison-of-space-glucose-control-and-routine-glucose-management-protocol-for-glycemic-control-in-critically-ill-patients-a-prospective-randomized-clinical-study
#9
Biao Xu, Wei Jiang, Chun-Yao Wang, Li Weng, Xiao-Yun Hu, Jin-Min Peng, Bin Du
BACKGROUND: The Space Glucose Control (SGC) system is a computer-assisted device combining infusion pumps with the enhanced Model Predictive Control algorithm to achieve the target blood glucose (BG) level safely. The objective of this study was to evaluate the efficacy and safety of glycemic control by SGC with customized BG target range of 5.8-8.9 mmol/L in the critically ill patients. METHODS: It is a randomized controlled trial of seventy critically ill patients with mechanical ventilation and hyperglycemia (BG ≥ 9...
September 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28742432/controversies-surrounding-critical-care-nutrition-an-appraisal-of-permissive-underfeeding-protein-and-outcomes
#10
Jayshil J Patel, Robert G Martindale, Stephen A McClave
Over the past few years, numerous studies have called into question the optimal dose, timing, composition, and advancement rate of nutrition during the early acute phase of critical illness. These studies suggest permissive underfeeding with slow advancement may be more beneficial than aggressive full feeding. These counterintuitive results were possibly explained by enhanced autophagy, less hyperglycemia, or prevention of refeeding syndrome. This review underscores the controversies surrounding permissive underfeeding, aims to answer whether permissive underfeeding is appropriate for all critically ill patients, describes the impact of optimal protein delivery on critical care outcomes, discusses nutrition risk, and cogitates on the impact of nutrition on critical care outcomes...
July 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28737575/diabetes-is-not-associated-with-increased-90-day-mortality-risk-in-critically-ill-patients-with-sepsis
#11
Lonneke A van Vught, Rebecca Holman, Evert de Jonge, Nicolette F de Keizer, Tom van der Poll
OBJECTIVES: To determine the association of pre-existing diabetes, hyperglycemia, and hypoglycemia during the first 24 hours of ICU admissions with 90-day mortality in patients with sepsis admitted to the ICU. DESIGN: We used mixed effects logistic regression to analyze the association of diabetes, hyperglycemia, and hypoglycemia with 90-day mortality (n = 128,222). SETTING: All ICUs in the Netherlands between January 2009 and 2014 that participated in the Dutch National Intensive Care Evaluation registry...
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28724042/hyperglycemia-in-critical-patients-determinants-of-insulin-dose-choice
#12
Aline Klitzke Paliosa, Cassiano Teixeira, Regis Goulart Rosa, Carine Raquel Blatt
Objective: To identify factors that can determine the choice of intermittent subcutaneous regular insulin dose in critically ill patients with hyperglycemia. Method: Cross-sectional study in a general adult ICU with 26 beds, data collected between September and October 2014. The variables analyzed were: sex, age, previous diagnosis of diabetes mellitus, use of corticosteroids, use of lactulose, sepsis, fasting, enteral nutrition, use of dextrose 5% in water, NPH insulin prescription and blood glucose level...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28708678/dysglycemia-glycemic-variability-and-outcome-after-cardiac-arrest-and-temperature-management-at-33%C3%A2-c-and-36%C3%A2-c
#13
RANDOMIZED CONTROLLED TRIAL
Ola Borgquist, Matt P Wise, Niklas Nielsen, Nawaf Al-Subaie, Julius Cranshaw, Tobias Cronberg, Guy Glover, Christian Hassager, Jesper Kjaergaard, Michael Kuiper, Ondrej Smid, Andrew Walden, Hans Friberg
OBJECTIVES: Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes of patients randomized to targeted temperature management at 33°C or 36°C after cardiac arrest. DESIGN: Post hoc analysis of the multicenter TTM-trial. Primary outcome of this analysis was neurologic outcome after 6 months, referred to as "Cerebral Performance Category...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28511644/relationship-between-glycemic-levels-and-treatment-outcome-among-critically-ill-children-admitted-into-emergency-room-in-enugu
#14
Nwachinemere Davidson Uleanya, Elias Chikee Aniwada, Ikenna Chidiebele Nwokoye, Ikenna Kingsley Ndu, Christopher Bismarck Eke
BACKGROUND: Critically ill children are those in need of immediate attention on arrival to an emergency room. The importance of glycemic level measurement as well as maintaining the patency of the airway, effective breathing and circulation cannot be overemphasied. It has been highlighted that the peak hyperglycemia and hypoglycemia predict poor prognosis, longer lengths of hospital stay and higher mortality. The study aims to assess the relationship between glycemic level and treatment outcomes as well as length of hospital stay...
May 16, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28497374/the-effect-of-insulin-administration-on-c-peptide-in-critically-ill-patients-with-type-2-diabetes
#15
Marco Crisman, Luca Lucchetta, Nora Luethi, Luca Cioccari, Que Lam, Glenn M Eastwood, Rinaldo Bellomo, Johan Mårtensson
BACKGROUND: In critically ill patients with permissive hyperglycemia, it is uncertain whether exogenous insulin administration suppresses or enhances c-peptide secretion (a marker of pancreatic beta-cell response). We aimed to explore this effect in patients with type 2 diabetes. METHODS: We prospectively enrolled a cohort of 45 critically ill patients with type 2 diabetes managed according to a liberal glucose protocol (target blood glucose 10-14 mmol/l). We recorded the administration of insulin and oral hypoglycemic agents and measured plasma c-peptide as surrogate marker of endogenous insulin secretion on the first two consecutive days in ICU...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#16
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
July 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28400681/blood-glucose-variability-and-outcomes-in-critically-ill-children
#17
Kirti Mahadeorao Naranje, Banani Poddar, Arpita Bhriguvanshi, Richa Lal, Afzal Azim, Ratender K Singh, Mohan Gurjar, Arvind K Baronia
OBJECTIVES: To find the incidence of hyperglycemia (blood glucose [BG] ≥150 mg/dl), hypoglycemia (BG ≤60 mg/dl), and variability (presence of hypoglycemia and hyperglycemia) in critically ill children in the 1(st) week of Intensive Care Unit (ICU) stay and their association with mortality, length of ICU stay, and organ dysfunction. MATERIALS AND METHODS: The design was a retrospective observational cohort study. Consecutive children ≤18 years of age admitted from March 2003 to April 2012 in a combined adult and pediatric closed ICU...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28344751/management-of-critically-ill-patients-with-diabetes
#18
REVIEW
Livier Josefina Silva-Perez, Mario Alberto Benitez-Lopez, Joseph Varon, Salim Surani
Disorders of glucose homeostasis, such as stress-induced hypoglycemia and hyperglycemia, are common complications in patients in the intensive care unit. Patients with preexisting diabetes mellitus (DM) are more susceptible to hyperglycemia, as well as a higher risk from glucose overcorrection, that may results in severe hypoglycemia. In critically ill patients with DM, it is recommended to maintain a blood glucose range between 140-180 mg/dL. In neurological patients and surgical patients, tighter glycemic control (i...
March 15, 2017: World Journal of Diabetes
https://www.readbyqxmd.com/read/28319802/associations-between-home-insulin-dose-adjustments-and-glycemic-outcomes-at-hospital-admission
#19
Saira Khan, Sherita Hill Golden, Nestoras Mathioudakis
AIMS: To describe patterns of home insulin dose adjustments for non-surgical, non-critically ill patients at admission and to describe associations between these adjustments and inpatient glycemic control. METHODS: Hospital records of non-critically ill patients treated with basal insulin prior to admission were identified. After exclusion of records in which a confounding factor influencing insulin dosing was present, 258 patient-admissions over a 3-year time period were included...
May 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28302323/new-onset-diabetes-after-acute-and-critical-illness-a-systematic-review
#20
REVIEW
Chirag J Jivanji, Varsha M Asrani, John A Windsor, Maxim S Petrov
Hyperglycemia is commonly observed during acute and critical illness. Recent studies have investigated the risk of developing diabetes after acute and critical illness, but the relationship between degree of in-hospital hyperglycemia and new-onset diabetes has not been investigated. This study examines the evidence for the relationship between in-hospital hyperglycemia and prevalence of new-onset diabetes after acute and critical illness. A literature search was performed of the MEDLINE, EMBASE, and Scopus databases for relevant studies published from January 1, 2000, through August 4, 2016...
May 2017: Mayo Clinic Proceedings
keyword
keyword
79944
1
2
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"