scholarly journals Metformin Use and Metformin-associated Lactic Acidosis in Intensive Care Unit Patients with Diabetes

Cureus ◽  
2019 ◽  
Author(s):  
Venkat Rajasurya ◽  
Humayun Anjum ◽  
Salim Surani
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lactic Acidosis ◽  
Patients With Diabetes

scholarly journals Metformin-associated lactic acidosis in an intensive care unit

Critical Care ◽  
2008 ◽  
Vol 12 (6) ◽  
pp. R149 ◽  
Author(s):  
Nicolas Peters ◽  
Nicolas Jay ◽  
Damien Barraud ◽  
Aurélie Cravoisy ◽  
Lionel Nace ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lactic Acidosis

scholarly journals CLINICAL CHARACTERISTICS OF 28 PATIENTS WITH DIABETES AND COVID-19 IN WUHAN, CHINA

2020 ◽  
Vol 26 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Feng Wang ◽  
Yan Yang ◽  
Kun Dong ◽  
Yongli Yan ◽  
Shujun Zhang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Invasive Mechanical Ventilation ◽  
Icu Patients ◽  
Patients With Diabetes

Objective: Previous studies on coronavirus disease 2019 (COVID-19) were based on information from the general population. We aimed to further clarify the clinical characteristics of diabetes with COVID-19. Methods: Twenty-eight patients with diabetes and COVID-19 were enrolled from January 29, 2020, to February 10, 2020, with a final follow-up on February 22, 2020. Epidemiologic, demographic, clinical, laboratory, treatment, and outcome data were analyzed. Results: The average age of the 28 patients was 68.6 ± 9.0 years. Most (75%) patients were male. Only 39.3% of the patients had a clear exposure of COVID-19. Fever (92.9%), dry cough (82.1%), and fatigue (64.3%) were the most common symptoms, followed by dyspnea (57.1%), anorexia (57.1%), diarrhea (42.9%), expectoration (25.0%), and nausea (21.4%). Fourteen patients were admitted to the intensive care unit (ICU). The hemoglobin A1c level was similar between ICU and non-ICU patients. ICU patients had a higher respiratory rate, higher levels of random blood glucose, aspartate transaminase, bilirubin, creatine, N-terminal prohormone of brain natriuretic peptide, troponin I, D-dimers, procalcitonin, C-reactive protein, ferritin, interleukin (IL)-2R, IL-6, and IL-8 than non-ICU patients. Eleven of 14 ICU patients received noninvasive ventilation and 7 patients received invasive mechanical ventilation. Twelve patients died in the ICU group and no patients died in the non-ICU group. Conclusion: ICU cases showed higher rates of organ failure and mortality than non-ICU cases. The poor outcomes of patients with diabetes and COVID-19 indicated that more supervision is required in these patients. Abbreviations: COVID-19 = coronavirus disease 2019; ICU = intensive care unit; MERS-CoV = middle East respiratory syndrome-related coronavirus; 2019- nCoV = 2019 novel coronavirus; NT-proBNP = N-terminal prohormone of brain natriuretic peptide; SARS-CoV = severe acute respiratory syndrome-related coronavirus

Management of Patients with Diabetes in the Intensive Care Unit

2019 ◽  
pp. 1293-1296.e2 ◽  
Author(s):  
Jacek Cieslak ◽  
Adeera Levin ◽  
Monica Beaulieu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patients With Diabetes

scholarly journals Prevalence of Diabetes and Hypertension and Their Associated Risks for Poor Outcomes in Covid-19 Patients

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Francisco J Barrera ◽  
Skand Shekhar ◽  
Rachel Wurth ◽  
Pablo J Moreno-Pena ◽  
Oscar J Ponce ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Relative Risk ◽  
Intensive Care Unit Admission ◽  
Observational Studies ◽  
Risk Of Bias ◽  
Patients With Diabetes ◽  
Registration Number ◽  
Poor Outcomes ◽  
Study Participants

Abstract Coronavirus disease 2019 (Covid-19) has affected millions of people and may disproportionately affect those with hypertension and diabetes. Because of inadequate methods in published systematic reviews, the prevalence of diabetes and hypertension and associated risks of poor outcomes in Covid-19 patients are unknown. We searched databases from December 1, 2019, to April 6, 2020, and selected observational peer-reviewed studies in English of patients with Covid-19. Independent reviewers extracted data on study participants, interventions, and outcomes and assessed risk of bias, and the certainty of evidence. We included 65 (15 794 participants) observational studies at moderate to high risk of bias. Overall prevalence of diabetes and hypertension was 12% (95% confidence interval [CI], 10-15; n = 12 870; I2: 89%), and 17% (95% CI, 13-22; n = 12 709; I2: 95%), respectively. In severe Covid-19, the prevalence of diabetes and hypertension were 18% (95% CI, 16-20; n = 1099; I2: 0%) and 32% (95% CI, 16-54; n = 1078; I2: 63%), respectively. Unadjusted relative risk for intensive care unit admission and mortality were 1.96 (95% CI, 1.19-3.22; n = 8890; I2: 80%; P = .008) and 2.78 (95% CI, 1.39-5.58; n = 2058; I2: 75%; P = .0004) for diabetics; and 2.95 (95% CI, 2.18-3.99; n = 1737; I2: 0%; P < .001) and 2.39 (95% CI, 1.54-3.73; n = 3107; I2: 66%; P < .001) for hypertensives. Neither diabetes (1.50; 95% CI, 0.90-2.50; n = 1991; I2: 74%; P = .119) nor hypertension (1.48; 95% CI, 0.99-2.23; n = 2023; I2: 69%; P = .058) was associated with severe Covid-19. In conclusion, the risk of intensive care unit admission and mortality for patients with diabetes or hypertension who developed Covid-19 is increased compared with those without these comorbidities. PROSPERO registration number CRD42020176582.

Necrotizing Skin and Soft Tissue Infections Admitted to Intensive Care Unit in Reunion Island: A Retrospective Cohort Study

2021 ◽  
Author(s):  
David Vandroux ◽  
Alexia Mubuanga Nkusu ◽  
Bernard-Alex Gauzere ◽  
Olivier Martinet
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Soft Tissue ◽  
Gram Negative Bacteria ◽  
Soft Tissue Infections ◽  
Reunion Island ◽  
Single Center Study ◽  
Patients With Diabetes ◽  
Réunion Island ◽  
Inflammatory Drugs

This retrospective and single-center study in Reunion Island (Indian Ocean) assessed frequency, mortality, causative pathogens of severe necrotizing skin, and necrotizing skin and soft tissue infections (NSSTIs) admitted in intensive care unit (ICU). Sixty-seven consecutive patients were included from January 2012 to December 2018. Necrotizing skin and soft tissue infection represented 1.06% of total ICU admissions. We estimate the incidence of NSSTI requiring ICU at 1.21/100,000 person/years in Reunion Island. Twenty (30%) patients were receiving nonsteroidal anti-inflammatory drugs (NSAIDs) prior to admission in ICU and 40 (60%) were diagnosed patients with diabetes. Sites of infection were the lower limb in 52 (78%) patients, upper limb in 4 (6%), and perineum in 10 (15%). The surgical treatment was debridement for 40 patients, whereas 11 patients required an amputation. The most commonly isolated microorganisms were Streptococci (42%) and Gram-negative bacteria (22%).The mortality rate was 25.4%. NSAIDs did not influence mortality when interrupted upon admission to ICU.

Patients with Severe Lactic Acidosis in the Intensive Care Unit: A Retrospective Study of Contributing Factors and Impact of Renal Replacement Therapy

2021 ◽  
pp. 1-7
Author(s):  
Lyssa Van De Ginste ◽  
Floris Vanommeslaeghe ◽  
Eric A.J. Hoste ◽  
Jan M. Kruse ◽  
Wim Van Biesen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Lactic Acidosis ◽  
Replacement Therapy ◽  
Lactate Level ◽  
Cohort Analysis ◽  
Adverse Outcomes ◽  
Contributing Factors ◽  
Severe Lactic Acidosis

<b><i>Introduction:</i></b> Hyperlactatemia is a regular condition in the intensive care unit, which is often associated with adverse outcomes. Control of the triggering condition is the most effective treatment of hyperlactatemia, but since this is mostly not readily possible, extracorporeal renal replacement therapy (RRT) is often tried as a last resort. The present study aims to evaluate the factors that may contribute to the decision whether to start RRT or not and the potential impact of the start of RRT on the outcome in patients with severe lactic acidosis (SLA) (lactate ≥5 mmol/L). <b><i>Materials and Methods:</i></b> We conducted a retrospective single-center cohort analysis over a 3-year period including all patients with a lactate level ≥5 mmol/L. Patients were considered as treated with RRT because of SLA if RRT was started within 24 h after reaching a lactate level ≥5 mmol/L. <b><i>Results:</i></b> Overall, 90-day mortality in patients with SLA was 34.5%. Of the 1,203 patients who matched inclusion/exclusion criteria, 11% (<i>n</i> = 133) were dialyzed within 24 h. The propensity to receive RRT was related to the lactate level and to the SOFA renal and cardio score. The most frequently used modality was continuous RRT. Patients who were started on RRT versus those who did not have 2.3 higher odds of mortality, even after adjustment for the propensity to start RRT. <b><i>Conclusions:</i></b> Our analysis confirms the high mortality rate of patients with SLA. It adds that odds for mortality is even higher in patients who were started on RRT versus not. We suggest keeping an open mind to the factors that may influence the decision to start dialysis and bear in mind that without being a bridge to correction of the underlying condition, dialysis is unlikely to affect the outcome.

scholarly journals The association between intensive care unit admission and subsequent depression in patients with diabetes

2011 ◽  
Vol 27 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Dimitry S. Davydow ◽  
Catherine L. Hough ◽  
Joan E. Russo ◽  
Michael Von Korff ◽  
Evette Ludman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Patients With Diabetes
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