L M Silveira1, A Basile-Filho2, E A Nicolini3, C A M Dessotte4, G C S Aguiar5, A M Stabile6. 1. Fundamental Nursing Program, College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil. Electronic address: lauramsilveira@yahoo.com.br. 2. Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, São Paulo, Brazil. 3. Division of Intensive Care, Department of Surgery and Anatomy, Hospital of the Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil. 4. Department of General and Specialized Nursing, College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil. 5. College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil. 6. College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil. Electronic address: angelita@eerp.usp.br.
Abstract
BACKGROUND: Sepsis is associated with morbidity and mortality, which implies high costs to the global health system. Metabolic alterations that increase glycaemia and glycaemic variability occur during sepsis. OBJECTIVE: To verify mean body glucose levels and glycaemic variability in Intensive Care Unit (ICU) patients with severe sepsis or septic shock. METHOD: Retrospective and exploratory study that involved collection of patients' sociodemographic and clinical data and calculation of severity scores. Glycaemia measurements helped to determine glycaemic variability through standard deviation and mean amplitude of glycaemic excursions. RESULTS: Analysis of 116 medical charts and 6730 glycaemia measurements revealed that the majority of patients were male and aged over 60 years. Surgical treatment was the main reason for ICU admission. High blood pressure and diabetes mellitus were the most usual comorbidities. Patients that died during the ICU stay presented the highest SOFA scores and mean glycaemia; they also experienced more hypoglycaemia events. Patients with diabetes had higher mean glycaemia, evaluated through standard deviation and mean amplitude of glycaemia excursions. CONCLUSION: Organic impairment at ICU admission may underlie glycaemic variability and lead to a less favourable outcome. High glycaemic variability in patients with diabetes indicates that monitoring of these individuals is crucial to ensure better outcomes.
BACKGROUND:Sepsis is associated with morbidity and mortality, which implies high costs to the global health system. Metabolic alterations that increase glycaemia and glycaemic variability occur during sepsis. OBJECTIVE: To verify mean body glucose levels and glycaemic variability in Intensive Care Unit (ICU) patients with severe sepsis or septic shock. METHOD: Retrospective and exploratory study that involved collection of patients' sociodemographic and clinical data and calculation of severity scores. Glycaemia measurements helped to determine glycaemic variability through standard deviation and mean amplitude of glycaemic excursions. RESULTS: Analysis of 116 medical charts and 6730 glycaemia measurements revealed that the majority of patients were male and aged over 60 years. Surgical treatment was the main reason for ICU admission. High blood pressure and diabetes mellitus were the most usual comorbidities. Patients that died during the ICU stay presented the highest SOFA scores and mean glycaemia; they also experienced more hypoglycaemia events. Patients with diabetes had higher mean glycaemia, evaluated through standard deviation and mean amplitude of glycaemia excursions. CONCLUSION: Organic impairment at ICU admission may underlie glycaemic variability and lead to a less favourable outcome. High glycaemic variability in patients with diabetes indicates that monitoring of these individuals is crucial to ensure better outcomes.
Authors: Andrea Fabbri; Giulio Marchesini; Barbara Benazzi; Alice Morelli; Danilo Montesi; Cesare Bini; Stefano Giovanni Rizzo Journal: Crit Care Explor Date: 2020-07-15
Authors: Seong Ho Kim; Ji Young Kim; Eun Song Kim; Il Rae Park; Eun Yeong Ha; Seung Min Chung; Jun Sung Moon; Ji Sung Yoon; Kyu Chang Won; Hyoung Woo Lee Journal: Ann Med Date: 2022-12 Impact factor: 5.348