Abstract:
PURPOSE:Hyperglycaemia is common in the critically ill. The objectives of this study were to determine the prevalence of critical illness-associated hyperglycaemia (CIAH) and recognised and unrecognised diabetes in the critically ill as well as to evaluate the impact of premorbid glycaemia on the association between acute hyperglycaemia and mortality. METHODS:In 1,000 consecutively admitted patients we prospectively measured glycated haemoglobin (HbA1c) on admission, and blood glucose concentrations during the 48 h after admission, to the intensive care unit. Patients with blood glucose ≥7.0 mmol/l when fasting or ≥11.1 mmol/l during feeding were deemed hyperglycaemic. Patients with acute hyperglycaemia and HbA1c <6.5% (48 mmol/mol) were categorised as 'CIAH', those with known diabetes as 'recognised diabetes', and those with HbA1c ≥6.5% but no previous diagnosis of diabetes as 'unrecognised diabetes'. The remainder were classified as 'normoglycaemic'. Hospital mortality, HbA1c and acute peak glycaemia were assessed using a logistic regression model. RESULTS:Of 1,000 patients, 498 (49.8%) had CIAH, 220 (22%) had recognised diabetes, 55 (5.5%) had unrecognised diabetes and 227 (22.7%) were normoglycaemic. The risk of death increased by approximately 20% for each increase in acute glycaemia of 1 mmol/l in patients with CIAH and those with diabetes and HbA1c levels <7% (53 mmol/mol), but not in patients with diabetes and HbA1c ≥7%. This association was lost when adjusted for severity of illness. CONCLUSIONS:Critical illness-associated hyperglycaemia is the most frequent cause of hyperglycaemia in the critically ill. Peak glucose concentrations during critical illness are associated with increased mortality in patients with adequate premorbid glycaemic control, but not in patients with premorbid hyperglycaemia. Optimal glucose thresholds in the critically ill may, therefore, be affected by premorbid glycaemia.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Plummer MP,Bellomo R,Cousins CE,Annink CE,Sundararajan K,Reddi BA,Raj JP,Chapman MJ,Horowitz M,Deane AMdoi
10.1007/s00134-014-3287-7subject
Has Abstractpub_date
2014-07-01 00:00:00pages
973-80issue
7eissn
0342-4642issn
1432-1238journal_volume
40pub_type
临床试验,杂志文章abstract:PURPOSE:Bioactive NO carriers in circulating blood formed during NO inhalation selectively distribute blood flow to areas in need, and may thus improve collateral perfusion to the area-at-risk in acute myocardial infarction (AMI). Here, we tested the hypothesis that NO inhalation during the ischemic phase of AMI may im...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2605-1
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abstract:: ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-018-5213-x
更新日期:2019-01-01 00:00:00
abstract::In a randomized clinical trial the prophylactic effects of locally administered antimicrobials on quantitative colonization and respiratory infections were studied in intubated patients with an expected period of mechanical ventilation of greater than 6 days. Nineteen patients received 50 mg of polymyxin B and 80 mg o...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF00254795
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:Lung injury is a severe complication of acute pancreatitis that increases the mortality rate of the disease. The pathophysiology of acute pancreatitis has been studied in several experimental models, but the kinetics of pulmonary complications in relation to the pancreatic disease is not completely understood...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0264-9
更新日期:2006-11-01 00:00:00
abstract:PURPOSE:Little evidence of increased thrombotic risk is available in COVID-19 patients. Our purpose was to assess thrombotic risk in severe forms of SARS-CoV-2 infection. METHODS:All patients referred to 4 intensive care units (ICUs) from two centers of a French tertiary hospital for acute respiratory distress syndrom...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-020-06062-x
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abstract::Status epilepticus is one of the most frequent neurological emergencies in the intensive care unit. Standard treatment includes intravenous barbiturates, benzodiazepines and phenytoin. However, drug coma is sometimes necessary to control refractory status epilepticus. We report such a case, successfully treated by int...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01707672
更新日期:1994-01-01 00:00:00
abstract:PURPOSE:Venous thromboembolism (VTE) is a common but often overlooked life-threatening complication of critical illness. The aim of this cross-sectional survey was to assess current practice of thromboprophylaxis as well as adherence to international guidelines. METHODS:After ethics committee approval, all intensive c...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2533-0
更新日期:2012-06-01 00:00:00
abstract::We investigated the levels of auto-PEEP and dynamic hyperinflation during high frequency jet ventilation (HFJV) and controlled mechanical ventilation (CMV) in six patients with chronic obstructive pulmonary disease within the first 36 h of acute exacerbation. The comparative evaluation was performed at similar conditi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02575298
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVES:To establish priorities for research in critical care medicine in the UK using survey and nominal group (NG) techniques. DESIGN:The senior doctor and nurse from 325 intensive care units (ICUs) in the UK were invited to contribute up to ten research questions relevant to intensive care organisation, practice...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000628
更新日期:2000-10-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/s00134-003-1956-z
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:The Brugada syndrome is a clinical and electrocardiographic familial entity, which may lead to sudden cardiac death. A Brugada pattern ECG may occasionally be caused by conditions such as an overdose of tricyclic antidepressants (TCA). Toxicity of TCA frequently results in the need for critical care support. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-0007-3
更新日期:2006-02-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711544
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:To define the mechanisms of the stable and prolonged post-operative plasma volume expansion observed with Hydroxyethyl Starches (HES) and to determine whether a partial intravascular hydrolysis of large molecules contribute to reinforce the colloid-osmotic effect. DESIGN:Prospective, pharmacologic study usin...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/BF01700163
更新日期:1995-07-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000601
更新日期:2000-09-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-018-5159-z
更新日期:2018-05-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711907
更新日期:1994-08-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-013-3202-7
更新日期:2014-03-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2001-11-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2014-02-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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journal_title:Intensive care medicine
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340000635
更新日期:2000-12-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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journal_title:Intensive care medicine
pub_type: 杂志文章
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journal_title:Intensive care medicine
pub_type: 社论
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更新日期:2018-12-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:1985-01-01 00:00:00
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journal_title:Intensive care medicine
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journal_title:Intensive care medicine
pub_type: 杂志文章
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-018-5280-z
更新日期:2018-12-01 00:00:00