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.
Performance assessment of a glucose control protocol in septic patients with an automated intermittent plasma glucose monitoring device / M. Umbrello, V. Salice, P. Spanu, P. Formenti, A. Barassi, G.V. Melzi d'Eril, G. Iapichino. - In: CLINICAL NUTRITION. - ISSN 0261-5614. - 33:5(2014 Oct), pp. 867-871.
|Titolo:||Performance assessment of a glucose control protocol in septic patients with an automated intermittent plasma glucose monitoring device|
UMBRELLO, MICHELE (Primo)
SALICE, VALENTINA (Secondo)
MELZI D'ERIL, GIANLODOVICO (Penultimo)
IAPICHINO, GAETANO (Ultimo)
|Parole Chiave:||Automated glucose control ; Blood glucose ; Critically ill patients ; G/CHO ; Glucose control protocol ; NS ; Sepsis ; glucose/carbohydrate ; nutrition support|
|Settore Scientifico Disciplinare:||Settore MED/41 - Anestesiologia|
Settore BIO/12 - Biochimica Clinica e Biologia Molecolare Clinica
|Data di pubblicazione:||ott-2014|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.clnu.2013.10.007|
|Appare nelle tipologie:||01 - Articolo su periodico|