Effect of insulin therapy on coagulation and fibrinolysis in medical intensive care patients.

Abstract:

OBJECTIVE:Most intensive care deaths beyond the first few days of critical illness are attributable to nonresolving organ failure, either due to or coinciding with sepsis. One of the mechanisms that is thought to contribute to the pathogenesis of organ failure is microvascular thrombosis. Recently, we reported significant improved survival and prevention of organ failure with the use of intensive insulin therapy to maintain normoglycemia for at least several days. We hypothesize that intensive insulin therapy also prevents severe coagulation abnormalities thereby contributing to less organ failure and better survival. DESIGN:This was a preplanned subanalysis of a large randomized controlled study, conducted at a university hospital medical intensive care unit. The intervention was strict blood glucose control to normoglycemia with insulin. RESULTS:Mortality of intensive insulin-treated patients was lower than that of conventionally treated patients for all classes of upon-admission disseminated intravascular coagulation (DIC) scores, except for those patients with overt DIC scores of 6 or higher (for DIC < 5, p = 0.003; for DIC > or = 5, p = 0.4). There was no effect of insulin therapy on any of the fibrinolytic, coagulation, or inflammatory parameters tested. CONCLUSIONS:This negative observation does not support a key role for these systems in explaining the clinical benefit of intensive insulin therapy, although a short-lived effect within 5 days of treatment cannot be excluded.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Langouche L,Meersseman W,Vander Perre S,Milants I,Wouters PJ,Hermans G,Gjedsted J,Hansen TK,Arnout J,Wilmer A,Schetz M,Van den Berghe G

doi

10.1097/CCM.0b013e31816f7bae

subject

Has Abstract

pub_date

2008-05-01 00:00:00

pages

1475-80

issue

5

eissn

0090-3493

issn

1530-0293

journal_volume

36

pub_type

杂志文章,随机对照试验
  • Clinical experience with tight glucose control by intensive insulin therapy.

    abstract:OBJECTIVE:To describe the current status and the clinical data related to the effects of tight glucose control by intensive insulin therapy in critically ill patients. DESIGN:Review article. SETTING:University hospital. PATIENTS:Medical and surgical critically ill patients in whom a correlation between blood glucose...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.CCM.0000278046.24345.C7

    authors: Preiser JC,Devos P

    更新日期:2007-09-01 00:00:00

  • Timing of renal replacement therapy and patient outcomes in the randomized evaluation of normal versus augmented level of replacement therapy study.

    abstract:OBJECTIVES:To explore the relationship between timing of continuous renal replacement therapy commencement and clinical outcomes in critically ill patients with acute kidney injury. The primary outcomes were all-cause mortality at 28 and 90 days. DESIGN:Nested observational cohort study using data from the Randomized ...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/CCM.0000000000000343

    authors: Jun M,Bellomo R,Cass A,Gallagher M,Lo S,Lee J,Randomized Evaluation of Normal Versus Augmented Level of Replacement Therapy (RENAL) Study Investigators.

    更新日期:2014-08-01 00:00:00

  • Extracorporeal Membrane Oxygenation Can Successfully Support Patients With Severe Acute Respiratory Distress Syndrome in Lieu of Mechanical Ventilation.

    abstract:OBJECTIVES:Extracorporeal membrane oxygenation is increasingly used in the management of severe acute respiratory distress syndrome. With extracorporeal membrane oxygenation, select patients with acute respiratory distress syndrome can be managed without mechanical ventilation, sedation, or neuromuscular blockade. Publ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003354

    authors: Kurihara C,Walter JM,Singer BD,Cajigas H,Shayan S,Al-Qamari A,DeCamp MM,Wunderink R,Budinger GRS,Bharat A

    更新日期:2018-11-01 00:00:00

  • Noninvasive pulse oximetry in children with cyanotic congenital heart disease.

    abstract::Arterial oxygen saturation, determined noninvasively by pulse oximetry in 32 pediatric patients with cyanotic congenital heart disease (CHD), was compared with oxygen saturation measured by a cooximeter in simultaneously obtained arterial blood samples. The patients were studied in the cardiac catheterization laborato...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198711000-00015

    authors: Boxer RA,Gottesfeld I,Singh S,LaCorte MA,Parnell VA Jr,Walker P

    更新日期:1987-11-01 00:00:00

  • Occurrence and outcomes of sepsis: influence of race.

    abstract:OBJECTIVE:To evaluate premorbid conditions and sociodemographic characteristics associated with differences in hospitalization and mortality rates of sepsis in blacks and whites. DESIGN:Secondary data analysis of the publicly available New Jersey State Inpatient Database for 2002. SETTING:Acute care hospitals in New ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000256726.80998.BF

    authors: Dombrovskiy VY,Martin AA,Sunderram J,Paz HL

    更新日期:2007-03-01 00:00:00

  • Urgent coronary angiography and percutaneous coronary intervention as a part of postresuscitation management.

    abstract::Because an acute coronary thrombotic event may be viewed as the main trigger of sudden cardiac arrest, urgent coronary angiography followed by percutaneous coronary intervention appeared as a promising tool in the early postresuscitation phase. Unfortunately, large randomized trials, which have unequivocally demonstra...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/ccm.0b013e31818a8ae6

    authors: Noc M

    更新日期:2008-11-01 00:00:00

  • Impact of patient volume on the mortality rate of adult intensive care unit patients.

    abstract:OBJECTIVE:Expert task forces have proposed that adult critical care medicine services should be regionalized in order to improve outcomes. However, it is currently unknown if high intensive care unit (ICU) patient volumes are associated with reduced mortality rate. The objective was to investigate whether high-volume I...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000226415.93237.84

    authors: Glance LG,Li Y,Osler TM,Dick A,Mukamel DB

    更新日期:2006-07-01 00:00:00

  • Factors related to quality of life 12 months after discharge from an intensive care unit.

    abstract:OBJECTIVE:To perform an analysis of the quality of life of survivors after ICU discharge. DESIGN:Prospective study. SETTING:Medical-surgical ICU of a Spanish reference hospital. PATIENTS:Patients (n = 606) admitted in a 6-month period. METHOD:A questionnaire regarding quality of life issues was completed at the tim...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199209000-00012

    authors: Vazquez Mata G,Rivera Fernandez R,Gonzalez Carmona A,Delgado-Rodriguez M,Torres Ruiz JM,Raya Pugnaire A,Aguayo de Hoyos E

    更新日期:1992-09-01 00:00:00

  • Septic emboli caused by vascular catheters after surgery for congenital heart disease.

    abstract:OBJECTIVE:To review the incidence, diagnosis, and management of septic emboli caused by vascular catheters after surgery for congenital heart disease. DESIGN:Retrospective clinical review. All patients were computer registered. Our database includes daily follow-up and every sign of infection registered. SETTING:Pedi...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200003000-00039

    authors: Erez E,Sharoni E,Ovadia B,Vidne BA,Dagan O

    更新日期:2000-03-01 00:00:00

  • Hepatic Compartment Syndrome Following Percutaneous Cholecystostomy: A Case Report.

    abstract:OBJECTIVE:To describe a case of hepatic subcapsular hematoma causing an acute Budd-Chiari-like syndrome, leading to hepatic compartment syndrome, which combines compression of intrahepatic vessels on CT, acute liver failure, and refractory shock. DESIGN:Case report. SETTING:Surgical ICU of a university teaching hospi...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001403

    authors: Marcaire F,Malavieille F,Pichot-Delahaye V,Floccard B,Rimmelé T

    更新日期:2016-03-01 00:00:00

  • The Nursing Activities Score Per Nurse Ratio Is Associated With In-Hospital Mortality, Whereas the Patients Per Nurse Ratio Is Not.

    abstract:OBJECTIVES:Studies have shown contradicting results on the association of nursing workload and mortality. Most of these studies expressed workload as patients per nurse ratios; however, this does not take into account that some patients require more nursing time than others. Nursing time can be quantified by tools like...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004005

    authors: Margadant C,Wortel S,Hoogendoorn M,Bosman R,Spijkstra JJ,Brinkman S,de Keizer N

    更新日期:2020-01-01 00:00:00

  • Timing of Intubation and Mortality Among Critically Ill Coronavirus Disease 2019 Patients: A Single-Center Cohort Study.

    abstract:OBJECTIVES:Increasing time to mechanical ventilation and high-flow nasal cannula use may be associated with mortality in coronavirus disease 2019. We examined the impact of time to intubation and use of high-flow nasal cannula on clinical outcomes in patients with coronavirus disease 2019. DESIGN:Retrospective cohort ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004600

    authors: Hernandez-Romieu AC,Adelman MW,Hockstein MA,Robichaux CJ,Edwards JA,Fazio JC,Blum JM,Jabaley CS,Caridi-Scheible M,Martin GS,Murphy DJ,Auld SC,Emory COVID-19 Quality and Clinical Research Collaborative.

    更新日期:2020-11-01 00:00:00

  • Diagnosis and follow-up of infections in intensive care patients: value of C-reactive protein compared with other clinical and biological variables.

    abstract:OBJECTIVE:To evaluate diagnostic and prognostic values of C-reactive protein (CRP) dosage in critically ill patients. DESIGN:Prospective, observational study. SETTING:Medical intensive care unit (ICU) in a university hospital. PATIENTS:A consecutive series of 74 patients admitted to the ICU. INTERVENTION:CRP measur...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200203000-00006

    authors: Reny JL,Vuagnat A,Ract C,Benoit MO,Safar M,Fagon JY

    更新日期:2002-03-01 00:00:00

  • Acute respiratory distress syndrome complicating Plasmodium vivax malaria.

    abstract::Malaria is one of the most common infectious diseases in the world, and severe respiratory complications have been described mainly in association with Plasmodium falciparum. We describe a case of acute respiratory distress syndrome complicating infection with P. vivax in the setting of relatively low parasitemia in a...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200103000-00037

    authors: Tanios MA,Kogelman L,McGovern B,Hassoun PM

    更新日期:2001-03-01 00:00:00

  • Association between nurse-physician collaboration and patient outcomes in three intensive care units.

    abstract:OBJECTIVE:To investigate the association of collaboration between intensive care unit (ICU) physicians and nurses and patient outcome. DESIGN:Prospective, descriptive, correlational study using self-report instruments. SETTINGS:A community teaching hospital medical ICU, a university teaching hospital surgical ICU, an...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00003246-199909000-00045

    authors: Baggs JG,Schmitt MH,Mushlin AI,Mitchell PH,Eldredge DH,Oakes D,Hutson AD

    更新日期:1999-09-01 00:00:00

  • Impact of Sepsis Classification and Multidrug-Resistance Status on Outcome Among Patients Treated With Appropriate Therapy.

    abstract:OBJECTIVE:To assess the impact of sepsis classification and multidrug-resistance status on outcome in patients receiving appropriate initial antibiotic therapy. DESIGN:A retrospective cohort study. SETTING:Barnes-Jewish Hospital, a 1,250-bed teaching hospital. PATIENTS:Individuals with Enterobacteriaceae sepsis, sev...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001013

    authors: Burnham JP,Lane MA,Kollef MH

    更新日期:2015-08-01 00:00:00

  • Written information that relatives of adult intensive care unit patients would like to receive--a comparison to published recommendations and opinion of staff members.

    abstract:OBJECTIVE:Information booklets have not been assessed by the families of intensive care unit (ICU) patients. This study explored the information that the relatives of adult ICU patients wanted to find in the information booklets. DESIGN:Multicenter survey. SETTING:Twenty-three French ICUs. SUBJECTS:One close relativ...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/CCM.0b013e3181a03063

    authors: Soltner C,Lassalle V,Galienne-Bouygues S,Pottecher J,Floccard B,Delapierre L,Jungfer F,Sargentini C,Alberti C,Beydon L,Lifrea Group.

    更新日期:2009-07-01 00:00:00

  • Restoration of hormonal action and muscle protein.

    abstract::This review focuses on the effects of restoring hormonal levels and/or influence on muscle protein metabolism in the stressed state. We have highlighted our clinical experience in the administration of anabolic and anticatabolic agents in stressed clinical populations, primarily adult and pediatric burn injury, as wel...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.CCM.0000278529.44899.57

    authors: Ferrando AA,Wolfe RR

    更新日期:2007-09-01 00:00:00

  • Improving code team performance and survival outcomes: implementation of pediatric resuscitation team training.

    abstract:OBJECTIVE:To determine whether implementation of Composite Resuscitation Team Training is associated with improvement in survival to discharge and code team performance after pediatric in-hospital cardiopulmonary arrest. DESIGN, SETTING, AND SUBJECTS:We conducted a prospective observational study with historical contr...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3182a6439d

    authors: Knight LJ,Gabhart JM,Earnest KS,Leong KM,Anglemyer A,Franzon D

    更新日期:2014-02-01 00:00:00

  • The risk of nosocomial pneumonia is not increased during partial liquid ventilation.

    abstract:OBJECTIVE:To determine whether partial liquid ventilation (PLV) affects the risk of nosocomial pneumonia. STUDY DESIGN:To assess in vitro bacterial adhesion and viability after liquid perfluorocarbon exposure and to assess bacterial recovery after partial liquid ventilation in vivo in rabbits. SETTING:University anim...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199912000-00023

    authors: Sajan I,Scannapieco FA,Fuhrman BP,Steinhorn DM

    更新日期:1999-12-01 00:00:00

  • Pulmonary hypertension in acute respiratory failure.

    abstract::In order to examine the prognostic value of pulmonary arterial hypertension (PAH) in patients with moderate and severe acute respiratory failure (ARF), 225 patients with ARF who had been treated with mechanical ventilation and admitted to our ICU during a 3-yr period (January, 1983 to January, 1986) were prospectively...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198906000-00007

    authors: Villar J,Blazquez MA,Lubillo S,Quintana J,Manzano JL

    更新日期:1989-06-01 00:00:00

  • Optimal release time during airway pressure release ventilation in neonatal sheep.

    abstract:OBJECTIVE:To systematically investigate the effect of altering release time during airway pressure release ventilation in a neonatal animal model before and after oleic acid-induced acute lung injury. DESIGN:Prospective, nonrandomized, controlled study with repeated measures. SETTING:University research laboratory. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199403000-00020

    authors: Martin LD,Wetzel RC

    更新日期:1994-03-01 00:00:00

  • Are Peripherally Inserted Central Catheters Suitable for Cardiac Output Assessment With Transpulmonary Thermodilution?

    abstract:OBJECTIVES:Peripherally inserted central catheters are increasingly used in ICU as an alternative to centrally inserted central catheters for IV infusion. However, their reliability for hemodynamic measurements with transpulmonary thermodilution is currently unknown. We investigated the agreement between transpulmonary...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003917

    authors: D'Arrigo S,Sandroni C,Cacciola S,Dell'Anna AM,Pittiruti M,Annetta MG,Colosimo C,Antonelli M

    更新日期:2019-10-01 00:00:00

  • Functional Status Score for the ICU: An International Clinimetric Analysis of Validity, Responsiveness, and Minimal Important Difference.

    abstract:OBJECTIVES:To evaluate the internal consistency, validity, responsiveness, and minimal important difference of the Functional Status Score for the ICU, a physical function measure designed for the ICU. DESIGN:Clinimetric analysis. SETTINGS:Five international datasets from the United States, Australia, and Brazil. PA...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001949

    authors: Huang M,Chan KS,Zanni JM,Parry SM,Neto SG,Neto JA,da Silva VZ,Kho ME,Needham DM

    更新日期:2016-12-01 00:00:00

  • Toll-like receptor 2 plays a critical role in cardiac dysfunction during polymicrobial sepsis.

    abstract:OBJECTIVE:To determine the role of toll-like receptor 2 in cardiac dysfunction during polymicrobial sepsis. DESIGN:Controlled animal study. SETTING:University hospital research laboratory. SUBJECTS:Male C57BL/6, wild-type, toll-like receptor 2-/-. INTERVENTION:Polymicrobial peritonitis, a clinically relevant model ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3181d99e67

    authors: Zou L,Feng Y,Chen YJ,Si R,Shen S,Zhou Q,Ichinose F,Scherrer-Crosbie M,Chao W

    更新日期:2010-05-01 00:00:00

  • Opportunities to Improve Antibiotic Appropriateness in U.S. ICUs: A Multicenter Evaluation.

    abstract:OBJECTIVES:To use a standardized tool for a multicenter assessment of antibiotic appropriateness in ICUs and identify local antibiotic stewardship improvement opportunities. DESIGN:Pilot point prevalence conducted on October 5, 2016; point prevalence survey conducted on March 1, 2017. SETTING:ICUs in 12 U.S. acute ca...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004344

    authors: Trivedi KK,Bartash R,Letourneau AR,Abbo L,Fleisher J,Gagliardo C,Kelley S,Nori P,Rieg GK,Silver P,Srinivasan A,Vargas J,Ostrowsky B,Partnership for Quality Care (PQC) Inpatient Antimicrobial Stewardship Working Group.

    更新日期:2020-07-01 00:00:00

  • Metallothionein alleviates glutathione depletion-induced oxidative cardiomyopathy in murine hearts.

    abstract:OBJECTIVE:Antioxidant therapy has shown some promise in critical care medicine in which glutathione depletion and heart failure are often seen in critically ill patients. This study was designed to examine the impact of glutathione depletion and the free radical scavenger, metallothionein (MT), on cardiac function. DE...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e31817bf925

    authors: Ren J,Privratsky JR,Yang X,Dong F,Carlson EC

    更新日期:2008-07-01 00:00:00

  • Comparative scintigraphy in oleic acid pulmonary microvascular injury.

    abstract::Computerized gamma scintigraphy revealed a significant (p less than 0.001) rising lung:heart radioactivity ratio, which has been called "slope of injury" or "slope index", with both 99mTechnetium-tagged human serum albumin (99mTc-HSA) and 99mTechnetium-tagged red blood cells (99Tc-RBC) after 0.05 or 0.2 ml/kg iv oleic...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198201000-00008

    authors: Sugerman HJ,Hirsch JI,Tatum JL,Strash AM,Sharp DE,Greenfield LJ

    更新日期:1982-01-01 00:00:00

  • Management of upper airway obstruction in the intensive care unit.

    abstract::Three patients under observation in ICUs developed mechanical upper airway obstruction requiring surgical intervention for airway control. One patient was treated by tracheotomy placed through a vertical midline incision and 2 patients were treated by cricothyroidotomy followed by elective tracheostomy and closure of ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198108000-00004

    authors: Schecter WP,Wilson RS

    更新日期:1981-08-01 00:00:00

  • L-Arginine prevents air embolism-induced acute lung injury in rats.

    abstract:OBJECTIVE:Pulmonary air embolism, causing vessel obstruction and primary or secondary reactions of blood, can lead to acute lung injury. In addition, nitric oxide has been known to play a key role in various causes of lung injury. In this study we employed the isolated rat lung model to investigate the effects of l-arg...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000178175.54354.ea

    authors: Chu SJ,Lee TY,Yan HC,Lin SH,Li MH

    更新日期:2005-09-01 00:00:00