Hypoglycaemia is associated with a higher mortality in critically ill patients

A Jose Pereira,R Da Hora Passos,E Silva,D Nishimura,J Telles,M Lobato,T Correa,A Biasi Cavalcanti,F Pereira Almeida

doi:10.1186/cc7280

Abstract

Hypoglycaemia, a common complication of strict glucose control in critically ill patients, has controversial effects on mortality. The hyperglycaemic index (HGI) takes into account the unequal time distribution of blood glucose sampling and is a better predictor of death than other methods to quantify hyperglycaemia [1]. By analogy with the HGI, we defined the hypoglycaemic index (HGI-60) as the area above the glucose curve and lower than 60 mg/dl divided by the length of ICU stay. The objective of the study was to evaluate the effects of hypoglycaemia on inhospital mortality in critical care patients using a new method for quantification of hypoglycaemia, the hypoglycaemic index (HGI-60).

Highlights

There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient’s experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients
The 28-day mortality rate was significantly reduced to 42.4% compared with 56.7% in the control group (P = 0.049, operating room (OR) = 0.56; 95% cardiac index (CI) = 0.32 to 1.00)
Results of this study show that early tracheostomy, if perioperative complications

Summary

Introduction

There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient’s experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients. Conclusions Our data demonstrate that critically ill patients may be exposed to a higher FiO2 than that required to maintain adequate oxygenation These results highlight an area of ICU care that has received little study, with no published clinical trials examining the effect of FiO2 on outcome. Results Age, sex, the underlying disease and tumour stage (TNM classification), type of previous anticancer treatment, performance status, severity scores (APACHE II, Simplified Acute Physiology Score II, Sequential Organ Failure Assessment), ICU and hospital mortalities and hospital outcome at 3, 6 and 12 months were analysed. Clinical data of 277 post-transplantation patients admitted to the ICU were collected at admission and the SAPS 3 and APACHE II score calculated with respective estimated mortality rates.

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