Abstract:
BACKGROUND:We assessed the association of intravenous insulin and glucose infusion with intensive care unit (ICU) and hospital mortality. METHODS:For this retrospective association study, we used data from all patients admitted to a medical-surgical ICU between January 2012 and September 2017. We excluded patients admitted < 24 h, patients with a diabetic ketoacidosis, patients with a therapy restriction upon ICU admission and readmissions. Using multivariate logistic regression, we examined the relation between intravenous insulin and glucose infusion and ICU and hospital mortality for all patients. Additionally, we used the same model to analyze the outcomes for patients admitted > 72 h. RESULTS:Of 9507 eligible patients, 3966 were included. After correction for potential confounders, intravenous insulin was associated with ICU and hospital mortality in patients admitted > 24 h (n = 3966) (odds ratio (OR) 1.09 [95% CI 1.05-1.13] and 1.09 [95% CI 1.06-1.13] per 0.1 IU/kg added, respectively). Likewise, intravenous glucose was associated with ICU mortality (OR 1.01 [95% CI 1.00-1.01]) but not with hospital mortality and (OR 1.00 [95% CI 1.00-1.01]) per g/day added, respectively. In patients admitted > 72 h (n = 1550), insulin dose was associated with both ICU and hospital mortality (p = 0.002 and p < 0.001, respectively), but glucose infusion was not (p = 0.08 and p = 0.2, respectively). CONCLUSIONS:Intravenous insulin administration is associated with an increased risk of ICU and hospital mortality, after correction for potential confounders. Parenteral glucose administration was limited in amount but was still associated with ICU mortality. However, based on these results, it is unknown whether this association is an epiphenomenon, or represents a true harm of insulin and glucose administration.
journal_name
Ann Intensive Carejournal_title
Annals of intensive careauthors
van Steen SC,Rijkenberg S,van der Voort PHJ,DeVries JHdoi
10.1186/s13613-019-0507-xsubject
Has Abstractpub_date
2019-02-11 00:00:00pages
29issue
1issn
2110-5820pii
10.1186/s13613-019-0507-xjournal_volume
9pub_type
杂志文章abstract::This review examines the available evidence for targeting a specific mean arterial pressure (MAP) in sepsis resuscitation. The clinical data suggest that targeting an MAP of 65-70 mmHg in patients with septic shock who do not have chronic hypertension is a reasonable first approximation. Whereas in patients with chron...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-015-0085-5
更新日期:2015-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-020-00741-0
更新日期:2020-09-16 00:00:00
abstract:BACKGROUND:Middle East respiratory syndrome (MERS) is caused by a coronavirus (MERS-CoV) and is characterized by hypoxemic respiratory failure. The objective of this study is to compare the outcomes of MERS-CoV patients before and after the availability of extracorporeal membrane oxygenation (ECMO) as a rescue therapy ...
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doi:10.1186/s13613-017-0350-x
更新日期:2018-01-10 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-017-0243-z
更新日期:2017-12-01 00:00:00
abstract:: Microbiologists have extensively worked during the past decade on a particular phase of the bacterial cell cycle known as biofilm, in which single-celled individuals gather together to form a sedentary but dynamic community within a complex structure, displaying spatial and functional heterogeneity. In response to th...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-1-19
更新日期:2011-06-13 00:00:00
abstract:BACKGROUND:Aneurysmal subarachnoid hemorrhage (SAH) is a serious condition associated with high mortality rates and long-term disability. We investigated the impact of fluid balance on neurologic outcome after adjustment for possible confounders related to intensive care therapy and extra-cerebral organ failure during ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0128-6
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The Lung Injury Score (LIS) remains a commonly utilized measure of lung injury severity though the additive value of LIS to predict ARDS outcomes over the recent Berlin definition of ARDS, which incorporates severity, is not known. METHODS:We tested the association of LIS (in which scores range from 0 to 4,...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-4-4
更新日期:2014-02-18 00:00:00
abstract:BACKGROUND:Despite advances in supportive care, moderate-severe acute respiratory distress syndrome (ARDS) is associated with high mortality rates, and novel therapies to treat this condition are needed. Compelling pre-clinical data from mouse, rat, sheep and ex vivo perfused human lung models support the use of human ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-014-0022-z
更新日期:2014-07-03 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-13
更新日期:2012-05-30 00:00:00
abstract:BACKGROUND:Intravenous crystalloid solutions are administered commonly for critically ill patients. We performed this meta-analysis of randomized trials with trial sequential analysis (TSA) to evaluate effects of chloride content of intravenous crystalloid solutions on clinical outcomes among critically ill adult patie...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0506-y
更新日期:2019-02-13 00:00:00
abstract:BACKGROUND:The echocardiography working group of the European Society of Intensive Care Medicine recognized the need to provide structured guidance for future CCE research methodology and reporting based on a systematic appraisal of the current literature. Here is reported this systematic appraisal. METHODS:We conduct...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-020-00662-y
更新日期:2020-04-25 00:00:00
abstract:BACKGROUND:Noninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxygen therapy (HFNT) might benefit patients with hypoxemia and can reduce physiological dead space. We hypothesized that HFNT and NIV would similarly reduce work of breathi...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0432-4
更新日期:2018-09-05 00:00:00
abstract:BACKGROUND:The value of goal-directed fluid therapy in neurosurgical patients, where brain swelling is a major concern, is unknown. The aim of our study was to evaluate the effect of an intraoperative goal-directed fluid restriction (GDFR) strategy on the postoperative outcome of high-risk patients undergoing brain sur...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0239-8
更新日期:2017-12-01 00:00:00
abstract::Jean-Luc Diehl The French Intensive Care Society organized on 5th and 6th June 2014 its 4th "Paris International Conference in Intensive Care", whose principle is to bring together the best international experts on a hot topic in critical care medicine. The 2014 theme was "Breakthrough in cardiac arrest", with many hi...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-015-0064-x
更新日期:2015-12-01 00:00:00
abstract::In the past, the only treatment of acute exacerbations of obstructive diseases with hypercapnic respiratory failure refractory to medical treatment was invasive mechanical ventilation (IMV). Considerable technical improvements transformed extracorporeal techniques for carbon dioxide removal in an attractive option to ...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-019-0551-6
更新日期:2019-07-02 00:00:00
abstract:BACKGROUND:During passive mechanical ventilation, the driving pressure of the respiratory system is an important mediator of ventilator-induced lung injury. Monitoring of driving pressure during assisted ventilation, similar to controlled ventilation, could be a tool to identify patients at risk of ventilator-induced l...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0477-4
更新日期:2019-01-03 00:00:00
abstract::Pharmacological interventions are commonly considered in acute respiratory distress syndrome (ARDS) patients. Inhaled nitric oxide (iNO) and neuromuscular blockers (NMBs) are used in patients with severe hypoxemia. No outcome benefit has been observed with the systematic use of iNO. However, a sometimes important impr...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-3-20
更新日期:2013-07-03 00:00:00
abstract:BACKGROUND:As the population ages and cancer therapies improve, there is an increased call for elderly cancer patients to be admitted to the intensive care unit (ICU). This study aimed to assess short-term survival and prognostic factors in critically ill patients with solid tumors aged ≥65 years. METHODS:We conducted...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0250-0
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Glucose control is an important issue in post-operative patients. The objective here was to compare two insulin infusion lines by syringe pumps to assess the impact of medical devices on glycaemic variability in surgical patients under intensive insulin therapy. This open, prospective, single-centre randomis...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0298-x
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The initial management of a trauma patient is a critical and demanding period. The use of extended focused assessment sonography for trauma (eFAST) has become more prevalent in trauma rooms, raising questions about the real "added value" of chest X-rays (CXRs) and pelvic X-rays (PXR), particularly in haemody...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0166-0
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Middle East respiratory syndrome coronavirus (MERS-CoV) has caused several hospital outbreaks, including a major outbreak at King Abdulaziz Medical City, a 940-bed tertiary-care hospital in Riyadh, Saudi Arabia (August-September 2015). To learn from our experience, we described the critical care response to ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0203-z
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Occlusion pressure at 100 ms (P0.1), defined as the negative pressure measured 100 ms after the initiation of an inspiratory effort performed against a closed respiratory circuit, has been shown to be well correlated with central respiratory drive and respiratory effort. Automated P0.1 measurement is availab...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0576-x
更新日期:2019-09-13 00:00:00
abstract:BACKGROUND:Empirical antimicrobial therapy (EAT) is a challenge for community-acquired, hospital-acquired and ventilator-associated pneumonia, particularly in the context of the increasing occurrence of third-generation cephalosporin-resistant Enterobacterales (3GCR-E), including extended-spectrum beta-lactamase Entero...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00754-9
更新日期:2020-10-29 00:00:00
abstract:BACKGROUND:Hypoxic hepatitis (HH) is a type of acute hepatic injury that is histologically characterized by centrilobular liver cell necrosis and that is caused by insufficient oxygen delivery to the hepatocytes. Typical for HH is the sudden and significant increase of aspartate aminotransferase (AST) in response to ca...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0356-z
更新日期:2018-01-30 00:00:00
abstract::Although improving, the mortality from septic shock still remains high despite increased international awareness. As a consequence, much effort has focused on alternative treatment strategies in an effort to improve outcomes. The application of blood purification therapies to improve immune homeostasis has been sugges...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-019-0530-y
更新日期:2019-05-14 00:00:00
abstract:BACKGROUND:Data on respiratory mechanics of COVID-19 ARDS patients are scarce. Respiratory mechanics and response to positive expiratory pressure (PEEP) may be different in obese and non-obese patients. METHODS:We investigated esophageal pressure allowing determination of transpulmonary pressures (PL ) and elastances ...
journal_title:Annals of intensive care
pub_type: 信件
doi:10.1186/s13613-020-00745-w
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:About 30% of patients with Guillain-Barré syndrome become ventilator dependent, of whom roughly 75% develop pneumonia. This trial aimed at assessing the impact of early mechanical ventilation (EMV) on pneumonia occurrence in GBS patients. We hypothesize that EMV will reduce the incidence of pneumonia. MET...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00742-z
更新日期:2020-09-30 00:00:00
abstract:: Human serum albumin (HSA) has been used for a long time as a resuscitation fluid in critically ill patients. It is known to exert several important physiological and pharmacological functions. Among them, the antioxidant properties seem to be of paramount importance as they may be implied in the potential beneficial ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-3-4
更新日期:2013-02-15 00:00:00
abstract:BACKGROUND:Acute respiratory distress syndrome (ARDS) patients may present impaired in lung function and structure after hospital discharge that may be related to mechanical ventilation strategy. The aim of this study was to evaluate the association between functional and structural lung impairment, N-terminal-peptide ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0469-4
更新日期:2018-12-07 00:00:00
abstract:BACKGROUND:Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether spe...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0173-1
更新日期:2016-12-01 00:00:00