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Hyperglycemia and ill critical patients

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https://www.readbyqxmd.com/read/27824941/establishment-and-validation-of-gv-saps-ii-scoring-system-for-non-diabetic-critically-ill-patients
#1
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
#2
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
#3
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
#4
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...
October 17, 2016: 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
#5
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...
October 4, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27736708/corticosteroids-and-neuromuscular-blockers-in-development-of-critical-illness-neuromuscular-abnormalities-a-historical-review
#6
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...
September 26, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27648697/interleukin-18-reduces-blood-glucose-and-modulates-plasma-corticosterone-in-a-septic-mouse-model
#7
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
#8
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
#9
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
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27315191/liberal-glycemic-control-in-critically-ill-patients-with-type-2-diabetes-an-exploratory-study
#12
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
https://www.readbyqxmd.com/read/27289842/il-6-and-its-correlation-to-stress-hyperglycemia-in-diabetic-and-non-diabetic-critically-ill-septic-patients
#13
A M Fayed, M M El-Sawy, Aa-E Mahrous, M E Soliman
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27257910/minimization-of-hypoglycemia-as-an-adverse-event-during-insulin-infusion-further-refinement-of-the-yale-protocol
#14
Michael R Marvin, Silvio E Inzucchi, Brian J Besterman
BACKGROUND: The management of hyperglycemia in the intensive care unit has been a controversial topic for more than a decade, with target ranges varying from 80-110 mg/dL to <200 mg/dL. Multiple insulin infusion protocols exist, including several computerized protocols, which have attempted to achieve these targets. Importantly, compliance with these protocols has not been a focus of clinical studies. METHODS: GlucoCare™, a Food and Drug Administration (FDA)-cleared insulin-dosing calculator, was originally designed based on the Yale Insulin Infusion Protocol to target 100-140 mg/dL and has undergone several modifications to reduce hypoglycemia...
August 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27229647/dysglycemia-and-glucose-control-during-sepsis
#15
REVIEW
Mark P Plummer, Adam M Deane
Sepsis predisposes to disordered metabolism and dysglycemia; the latter is a broad term that includes hyperglycemia, hypoglycemia, and glycemic variability. Dysglycemia is a marker of illness severity. Large randomized controlled trials have provided considerable insight into the optimal blood glucose targets for critically ill patients with sepsis. However, it may be that the pathophysiologic consequences of dysglycemia are dynamic throughout the course of a septic insult and also altered by premorbid glycemia...
June 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27176681/inpatient-hyperglycemia-management-a-practical-review-for-primary-medical-and-surgical-teams
#16
REVIEW
M Cecilia Lansang, Guillermo E Umpierrez
Inpatient hyperglycemia is common and is associated with an increased risk of hospital complications, higher healthcare resource utilization, and higher in-hospital mortality rates. Appropriate glycemic control strategies can reduce these risks, although hypoglycemia is a concern. In critically ill patients, intravenous (IV) insulin is most appropriate, with a starting threshold no higher than 180 mg/dL. Once IV insulin is started, the glucose level should be maintained between 140 and 180 mg/dL. In noncritically ill patients, basal-bolus regimens with basal, prandial, and correction components are preferred for those with good nutritional intake...
May 2016: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/27156888/common-neurodegenerative-pathways-in-obesity-diabetes-and-alzheimer-s-disease
#17
Subbiah Pugazhenthi, Limei Qin, P Hemachandra Reddy
Cognitive decline in chronic diabetic patients is a less investigated topic. Diabetes and obesity are among the modifiable risk factors for Alzheimer's disease (AD), the most common form of dementia. Studies have identified several overlapping neurodegenerative mechanisms, including oxidative stress, mitochondrial dysfunction, and inflammation that are observed in these disorders. Advanced glycation end products generated by chronic hyperglycemia and their receptor RAGE provide critical links between diabetes and AD...
May 6, 2016: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/27105121/accuracy-of-continuous-glucose-monitoring-in-patients-after-total-pancreatectomy-with-islet-autotransplantation
#18
Gregory P Forlenza, Brandon M Nathan, Antoinette Moran, Ty B Dunn, Gregory J Beilman, Timothy L Pruett, Boris P Kovatchev, Melena D Bellin
BACKGROUND: Among postsurgical and critically ill patients, malglycemia is associated with increased complications. Continuous glucose monitoring (CGM) in the inpatient population may enhance glycemic control. CGM reliability may be compromised by postsurgical complications such as edema or vascular changes. We utilized Clarke Error Grid (CEG) and Surveillance Error Grid (SEG) analysis to evaluate CGM performance after total pancreatectomy with islet autotransplantation. MATERIALS AND METHODS: This subanalysis evaluated Medtronic Enlite 2 CGM values against YSI serum glucose in seven post-transplant patients (86% female; 38...
August 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27076705/relationship-between-glycated-hemoglobin-intensive-care-unit-admission-blood-sugar-and-glucose-control-with-icu-mortality-in-critically-ill-patients
#19
Ata Mahmoodpoor, Hadi Hamishehkar, Kamran Shadvar, Mohammadtaghi Beigmohammadi, Afshin Iranpour, Sarvin Sanaie
BACKGROUND AND AIMS: The association between hyperglycemia and mortality is believed to be influenced by the presence of diabetes mellitus (DM). In this study, we evaluated the effect of preexisting hyperglycemia on the association between acute blood glucose management and mortality in critically ill patients. The primary objective of the study was the relationship between HbA1c and mortality in critically ill patients. Secondary objectives of the study were relationship between Intensive Care Unit (ICU) admission blood glucose and glucose control during ICU stay with mortality in critically ill patients...
February 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27052234/-treatment-of-hyperglycemia-in-adult-critically-ill-patients
#20
Martin Clodi, Michael Resl, Heidemarie Abrahamian, Bernhard Föger, Raimund Weitgasser
In critical illness hyperglycemia is associated with increased mortality. Based on the currently available evidence, an intravenous insulin therapy should be initiated when blood glucose is above 180 mg/dl. After initiation of insulin therapy blood glucose should be maintained between 140 and 180 mg/dl.
April 2016: Wiener Klinische Wochenschrift
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