التفاصيل البيبلوغرافية
| العنوان: |
Hypoglycemia Aggravates Critical Illness-Induced Neurocognitive Dysfunction. |
| المؤلفون: |
Dickmann, Annabelle, Volkert, Thomas, Wempe, Carola, Reinholz, Julia, Lohmann, Hubertus, Freise, Hendrik, Ellger, Björn, Duning, Thomas, van den Heuvel, Ingeborg |
| المصدر: |
Diabetes Care; Mar2010, Vol. 33 Issue 3, p639-644, 6p, 1 Diagram, 1 Chart |
| مصطلحات موضوعية: |
HYPOGLYCEMIA, CRITICALLY ill, DISEASE risk factors, INTENSIVE care units, COGNITION, GLYCEMIC index |
| مستخلص: |
OBJECTIVE -- Tight glycemic control (TGC) in critically ill patients is associated with an increased risk of hypoglycemia. Whether those short episodes of hypoglycemia are associated with adverse morbidity and mortality is a matter of discussion. Using a case-control study design, we investigated whether hypoglycemia under TGC causes permanent neurocognitive dysfunction in patients surviving critical illness. RESEARCH DESIGN AND METHODS -- From our patient data management system, we identified adult survivors treated for > 72 h in our surgical intensive care unit (ICU) between 2004 and 2007 (n = 4,635) without a history of neurocognitive dysfunction or structural brain abnormalities who experienced at least one episode of hypoglycemia during treatment (hypo group) (n = 37). For each hypo group patient, one patient stringently matched for demographic- and disease-related data were identified as a control subject. We performed a battery of neuropsychological tests investigating five areas of cognitive functioning in both groups at least 1 year after ICU discharge. Test results were compared with data from healthy control subjects and between groups. RESULTS -- Critical illness caused neurocognitive dysfunction in all tested domains in both groups. The dysfunction was aggravated in hypo group patients in one domain, namely that of visuospatial skills (P < 0.01). Besides hypoglycemia, both hyperglycemia (r= -0.322; P = 0.005) and fluctuations of blood glucose (r = -0.309; P = 0.008) were associated with worse test results in this domain. CONCLUSIONS -- Hypoglycemia was found to aggravate critical illness-induced neurocognitive dysfunction to a limited, but significant, extent; however, an impact of hyperglycemia and fluctuations of blood glucose on neurocognitive function cannot be excluded. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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