التفاصيل البيبلوغرافية
| العنوان: |
Hospital-acquired complications in intensive care unit patients with diabetes: A before-and-after study of a conventional versus liberal glucose control protocol. |
| المؤلفون: |
Luethi, Nora, Cioccari, Luca, Eastwood, Glenn, Biesenbach, Peter, Morgan, Rhys, Sprogis, Stephanie, Young, Helen, Peck, Leah, Knee Chong, Christine, Moore, Sandra, Moon, Kylie, Ekinci, Elif I., Deane, Adam M., Bellomo, Rinaldo, Mårtensson, Johan |
| المصدر: |
Acta Anaesthesiologica Scandinavica; Jul2019, Vol. 63 Issue 6, p761-768, 8p, 3 Charts |
| مصطلحات موضوعية: |
INTENSIVE care patients, PEOPLE with diabetes, DISEASE complications, HOSPITAL admission & discharge, GLUCOSE, DIABETES complications, BLOOD sugar analysis, TREATMENT of diabetes, INTENSIVE care units, RESEARCH, RESEARCH methodology, EVALUATION research, MEDICAL cooperation, CATASTROPHIC illness, COMPARATIVE studies, RESEARCH funding, LONGITUDINAL method |
| مستخلص: |
Background: Critically ill patients with diabetes mellitus (DM) are at increased risk of in-hospital complications and the optimal glycemic target for such patients remains unclear. A more liberal approach to glucose control has recently been suggested for patients with DM, but uncertainty remains regarding its impact on complications.Methods: We aimed to test the hypothesis that complications would be more common with a liberal glycemic target in ICU patients with DM. Thus, we compared hospital-acquired complications in the first 400 critically ill patients with DM included in a sequential before-and-after trial of liberal (glucose target: 10-14 mmol/L) vs conventional (glucose target: 6-10 mmol/L) glucose control.Results: Of the 400 patients studied, 165 (82.5%) patients in the liberal and 177 (88.5%) in the conventional-control group were coded for at least one hospital-acquired complication (P = 0.09). When comparing clinically relevant complications diagnosed between ICU admission and hospital discharge, we found no difference in the odds for infectious (adjusted odds ratio [aOR] for liberal-control: 1.15 [95% CI: 0.68-1.96], P = 0.60), cardiovascular (aOR 1.40 [95% CI: 0.63-3.12], P = 0.41) or neurological complications (aOR: 1.07 [95% CI: 0.61-1.86], P = 0.81), acute kidney injury (aOR 0.83 [95% CI: 0.43-1.58], P = 0.56) or hospital mortality (aOR: 1.09 [95% CI: 0.59-2.02], P = 0.77) between the liberal and the conventional-control group.Conclusion: In this prospective before-and-after study, liberal glucose control was not associated with an increased risk of hospital-acquired infectious, cardiovascular, renal or neurological complications in critically ill patients with diabetes. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
