Extremelt low rates of hypoglycemia following transfer of tight glucose control management to ICU nurses
نویسندگان
چکیده
Introduction / objectives Tight glucose control (TGC) failed to improve survival and has been associated with high rates (6-18%) of hypoglycemia (< 2.5mmol/l), themselves associated with significant mortality. Blood glucose levels vary largely in critically ills and TCG requires individualized knowledge of the patient condition. Bedside frequent blood glucose measurements are mandatory for continue adaptations of insulin and glucose administration. We progressively transfer TGC to the nursing personal.
منابع مشابه
Technical challenges and clinical outcomes of using a closed-loop glycemic control system in the hospital.
According to large randomized trials, results suggest that maintaining normoglycemia postoperatively through tight glycemic control (TGC) and intensive insulin therapy (IIT) can improve surgical outcomes as well as reduce mortality and morbidity in critically ill patients. However, trials examining the effects of TGC have had conflicting results. Systematic reviews and meta-analyses have also l...
متن کاملTowards continuous glucose monitoring in the ICU ¿Hacia una monitorización continua de glucosa en la UCI?
After the two landmark Leuven studies, glucose monitoring and control in the ICU were highlighted and opened an innovative research field that is here to stay. After those studies the target glucose control, tight or less stringent, and their related outcomes were not only a matter of cutting-edge investigations but also forced a decisive move from glucose control from paper-based to computer-b...
متن کاملEssential elements of the native glucoregulatory system, which, if appreciated, may help improve the function of glucose controllers in the intensive care unit setting.
In 2001, Van den Berghe and colleagues were able to show that tight glucose control decreases morbidity and mortality rates in the intensive care unit (ICU) setting. Several large, prospective, randomized controlled trials have failed to confirm these results. All of these studies attempted tight glucose control using expert-designed algorithms to adjust the rate of intravenous insulin. Unfortu...
متن کاملTight glycemic control versus standard care after pediatric cardiac surgery.
BACKGROUND In some studies, tight glycemic control with insulin improved outcomes in adults undergoing cardiac surgery, but these benefits are unproven in critically ill children at risk for hyperinsulinemic hypoglycemia. We tested the hypothesis that tight glycemic control reduces morbidity after pediatric cardiac surgery. METHODS In this two-center, prospective, randomized trial, we enrolle...
متن کاملIatrogenic hypoglycemia secondary to tight glucose control is an independent determinant for mortality and cardiac morbidity.
OBJECTIVE Evaluation of the effects of tight glycemia control in critically ill patients should include temporal as well as punctual glycemia data. METHODS Insulin drip was used to target intensive care unit (ICU) glucose levels between 80 and 126 mg dl⁻¹ in a consecutive series of adult cardiac surgery patients. ICU hourly glycemia was prospectively recorded. Glycemia standard deviation, hyp...
متن کامل