Hypoglycemia in a Surgical Intensive Care Unit
| Autor: | Lydia Lam, Natthida Owattanapanich, Kenji Inaba, Meghan Lewis, Morgan Schellenberg, Emily Switzer |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Quality management Iatrogenic Disease Surgical intensive care unit Hypoglycemia law.invention Postoperative Complications law Risk Factors medicine Humans Intensive care medicine Aged Retrospective Studies Aged 80 and over business.industry Incidence General Medicine Middle Aged medicine.disease Intensive care unit Los Angeles Intensive Care Units Female business |
| Zdroj: | The American surgeon. 87(10) |
| ISSN: | 1555-9823 |
| Popis: | Background Glycemic control is an important aspect of critical care because derangements are associated with morbidity and mortality. Patients at highest risk for hypoglycemia in the surgical intensive care unit (SICU) are incompletely described by existing literature. Our objective was to delineate this high-risk patient population in our SICU. Study Design In this single-center, retrospective, observational study, SICU patients admitted from June 1, 2019 to July 31, 2020 with ≥1 episode of hypoglycemia (blood glucose Results There were 41 hypoglycemic events in 27 patients, comprising an incidence of 1.5% among SICU patients. The most common admission diagnoses were cirrhosis (n = 13, 48%), polytrauma (n = 12, 44%), multisystem organ failure (n = 11, 41%), diabetes mellitus (n = 9, 33%), and soft tissue infection (n = 8, 30%). Four high-risk populations were identified: patients in multisystem organ failure (MSOF) (n = 11, 41%); those who were nil per os (NPO) (n = 10, 37%); patients receiving long acting subcutaneous insulin, for example, Lantus (n = 3, 11%); and those on continuous intravenous insulin infusions (n = 3, 11%). After multi-disciplinary peer review, most hypoglycemic events (n = 16, 59%) were deemed iatrogenic. Conclusions Hypoglycemia is rare in surgical critical care. When it does occur, patients are typically in MSOF, NPO, on long acting subcutaneous insulin or continuous insulin infusions, have soft tissue infections, or have acute or chronic liver failure. Increased vigilance with frequent blood glucose monitoring in these high-risk patients may reduce the risk of hypoglycemia in the SICU. |
| Databáze: | OpenAIRE |
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