Performance assessment of a glucose control protocol in septic patients with an automated intermittent plasma glucose monitoring device
| Autor: | Michele Umbrello, V. Salice, G. Iapichino, P. Spanu, Alessandra Barassi, Paolo Formenti, G.V. Melzi d’Eril |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Glucose control Critical Illness Coefficient of variation medicine.medical_treatment Pilot Projects Hypoglycemia Critical Care and Intensive Care Medicine Body Mass Index Sepsis Insulin resistance Internal medicine medicine Humans Hypoglycemic Agents Insulin Prospective Studies Aged Glycemic Nutrition and Dietetics business.industry Blood Glucose Self-Monitoring Glucose Measurement Middle Aged medicine.disease Intensive Care Units Endocrinology Hyperglycemia Anesthesia Female business Central venous catheter |
| Zdroj: | Clinical Nutrition. 33:867-871 |
| ISSN: | 0261-5614 |
| Popis: | Summary Background & aims The optimal level and modality of glucose control in critically ill patients is still debated. A protocolized approach and the use of nearly-continuous technologies are recommended to manage hyperglycemia, hypoglycemia and glycemic variability. We recently proposed a pato-physiology-based glucose control protocol which takes into account patient glucose/carbohydrate intake and insulin resistance. Aim of the present investigation was to assess the performance of our protocol with an automated intermittent plasma glucose monitoring device (OptiScanner™ 5000). Methods OptiScanner™ was used in 6 septic patients, providing glucose measurement every 15′ from a side-port of an indwelling central venous catheter. Target level of glucose was 80–150 mg/dL. Insulin infusion and kcal with nutritional support were also recorded. Results 6 septic patients were studied for 319 h (1277 measurements); 58 [45–65] hours for each patient (measurements/patient: 231 [172–265]). Blood glucose was at target for 93 [90–98]% of study time. Mean plasma glucose was 126 ± 11 mg/dL. Only 3 hypoglycemic episodes (78, 78, 69 mg/dL) were recorded. Glucose variability was limited: plasma glucose coefficient of variation was 11.7 ± 4.0% and plasma glucose standard deviation was 14.3 ± 5.5 mg/dL. Conclusions The local glucose control protocol achieved satisfactory glucose control in septic patients along with a high degree of safeness. Automated intermittent plasma glucose monitoring seemed useful to assess the performance of the protocol. |
| Databáze: | OpenAIRE |
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