scholarly journals Time-course evaluation of blood glucose changes in response to insulin delivery in critically ill patients

Critical Care ◽  
2014 ◽  
Vol 18 (Suppl 1) ◽  
pp. P440
Author(s):  
F Bass ◽  
S Bird ◽  
N Hammond ◽  
J Myburgh ◽  
S Finfer
Keyword(s):  
Blood Glucose ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Time Course ◽  
Insulin Delivery ◽  
Course Evaluation

scholarly journals Copeptin and stress-induced hyperglycemia in critically ill patients: A prospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250035
Author(s):  
Lilian Rodrigues Henrique ◽  
Daisy Crispim ◽  
Tarsila Vieceli ◽  
Ariell Freires Schaeffer ◽  
Priscila Bellaver ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Blood Glucose ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Time Course ◽  
Glycated Hemoglobin ◽  
Relevant Factor ◽  
Stress Hyperglycemia ◽  
A Prospective Study

Objectives Copeptin, an equimolar indicator of serum antidiuretic hormone levels, has been associated with higher mortality in critically ill patients and with the development of diabetes in the general population. The aim of the present study was to investigate the association of copeptin levels with glycemic parameters in critically ill patients and to compare the time-course of copeptin in survivors and non-survivors. Design Prospective cohort study. Patients From June to October 2019, critically ill patients were prospectively enrolled and followed for 90 days. Measurements Plasma copeptin levels were determined at intensive care unit (ICU) admission (copeptin T1), 24 h (copeptin T2), and 48 h (copeptin T3) after study entry. Blood glucose and glycated hemoglobin levels were measured. ICU, in-hospital, and 90-day mortality, and length of stay in the ICU and hospital were evaluated. Results 104 patients were included. No significant correlation was detected between copeptin levels and blood glucose (r = -0.17, p = 0.09), HbA1c (r = 0.01, p = 0.9), glycemic gap (r = -0.16, p = 0.11), and stress hyperglycemia ratio (r = -0.14, p = 0.16). Copeptin T3 levels were significantly higher in survivors than in non-survivors at hospital discharge (561 [370–856] vs 300 [231–693] pg/mL, p = 0.015) and at 90 days (571 [380–884] vs 300 [232–698] pg/mL, p = 0.03). Conclusions No significant correlations were found between copeptin levels and glycemic parameters, suggesting that copeptin is not a relevant factor in the induction of hyperglycemia during critical illness. Copeptin levels at ICU day 3 were higher in survivors than in non-survivors.

Time course of platelet counts in critically ill patients

2002 ◽  
Vol 30 (4) ◽  
pp. 753-756 ◽  
Author(s):  
Serdar Akca ◽  
Philip Haji-Michael ◽  
Arnaldo de Mendonça ◽  
Peter Suter ◽  
Marcel Levi ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Time Course ◽  
Platelet Counts

scholarly journals Continuous Glucose Monitoring in Critically Ill Patients With COVID-19: Results of an Emergent Pilot Study

2020 ◽  
Vol 14 (6) ◽  
pp. 1065-1073
Author(s):  
Archana R. Sadhu ◽  
Ivan Alexander Serrano ◽  
Jiaqiong Xu ◽  
Tariq Nisar ◽  
Jessica Lucier ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Pilot Study ◽  
Insulin Therapy ◽  
Critically Ill ◽  
Continuous Glucose Monitoring ◽  
Critically Ill Patients ◽  
Point Of Care ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Target Range

Background: Amidst the coronavirus disease 2019 (COVID-19) pandemic, continuous glucose monitoring (CGM) has emerged as an alternative for inpatient point-of-care blood glucose (POC-BG) monitoring. We performed a feasibility pilot study using CGM in critically ill patients with COVID-19 in the intensive care unit (ICU). Methods: Single-center, retrospective study of glucose monitoring in critically ill patients with COVID-19 on insulin therapy using Medtronic Guardian Connect and Dexcom G6 CGM systems. Primary outcomes were feasibility and accuracy for trending POC-BG. Secondary outcomes included reliability and nurse acceptance. Sensor glucose (SG) was used for trends between POC-BG with nursing guidance to reduce POC-BG frequency from one to two hours to four hours when the SG was in the target range. Mean absolute relative difference (MARD), Clarke error grids analysis (EGA), and Bland-Altman (B&A) plots were calculated for accuracy of paired SG and POC-BG measurements. Results: CGM devices were placed on 11 patients: Medtronic ( n = 6) and Dexcom G6 ( n = 5). Both systems were feasible and reliable with good nurse acceptance. To determine accuracy, 437 paired SG and POC-BG readings were analyzed. For Medtronic, the MARD was 13.1% with 100% of readings in zones A and B on Clarke EGA. For Dexcom, MARD was 11.1% with 98% of readings in zones A and B. B&A plots had a mean bias of −17.76 mg/dL (Medtronic) and −1.94 mg/dL (Dexcom), with wide 95% limits of agreement. Conclusions: During the COVID-19 pandemic, CGM is feasible in critically ill patients and has acceptable accuracy to identify trends and guide intermittent blood glucose monitoring with insulin therapy.

scholarly journals Saline versus 5% dextrose in water as a drug diluent for critically ill patients: a retrospective cohort study

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Yukari Aoyagi ◽  
Takuo Yoshida ◽  
Shigehiko Uchino ◽  
Masanori Takinami ◽  
Shoichi Uezono
Keyword(s):  
Blood Glucose ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Glucose Control ◽  
Blood Glucose Control ◽  
Kidney Injury ◽  
Saline Group ◽  
Significant Difference ◽  
The Impact ◽  
Electrolyte Abnormalities

Abstract Background The choice of intravenous infusion products for critically ill patients has been studied extensively because it can affect prognosis. However, there has been little research on drug diluents in this context. The purpose of this study is to evaluate the impact of diluent choice (saline or 5% dextrose in water [D5W]) on electrolyte abnormalities, blood glucose control, incidence of acute kidney injury (AKI), and mortality. Methods This before-after, two-group comparative, retrospective study enrolled adult patients who stayed for more than 48 h in a general intensive care unit from July 2015 to December 2018. We changed the default diluent for intermittent drug sets in our electronic ordering system from D5W to saline at the end of 2016. Results We included 844 patients: 365 in the D5W period and 479 in the saline period. Drug diluents accounted for 21.4% of the total infusion volume. The incidences of hypernatremia and hyperchloremia were significantly greater in the saline group compared to the D5W group (hypernatremia 27.3% vs. 14.6%, p < 0.001; hyperchloremia 36.9 % vs. 20.4%, p < 0.001). Multivariate analyses confirmed the similar effects (hypernatremia adjusted odds ratio (OR), 2.43; 95% confidence interval (CI), 1.54–3.82; hyperchloremia adjusted OR, 2.09; 95% CI, 1.31–3.34). There was no significant difference in the incidences of hyperglycemia, AKI, and mortality between the two groups. Conclusions Changing the diluent default from D5W to saline had no effect on blood glucose control and increased the incidences of hypernatremia and hyperchloremia.

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