Aims Dysglycemia, including the three domains hyperglycemia, hypoglycemia, and increased glycemic variability (GV), is associated with high mortality among critically ill patients. However, this association differs by diabetes status, and reports in this regard are limited. This study aimed to evaluate the associations between the three dysglycemia domains and mortality in critically ill patients by diabetes status and determined the contributing factors for dysglycemia. Methods This retrospective study included 958 critically ill patients (admitted to the ICU) with or without DM. Dysglycemia was defined as abnormality of any of the three dimensions. We evaluated the effects of the three domains of glucose control on mortality using binary logistic regression and then adjusted for confounders. The associations between dysglycemia and other variables were investigated using cumulative logistic regression analysis. Result GV independently and similarly affected mortality in both groups after adjustment for confounders (DM: odds ratio [OR], 1.05; 95% confidence interval [CI]: 1.03-1.08; p <0.001; non-DM: OR, 1.07; 95% CI, 1.03-1.11; p = 0.002). Hypoglycemia was strongly associated with ICU mortality among patients without DM (3.12; 1.76-5.53; p <0.001) and less so among those with DM (1.18; 0.49-2.83; p = 0.72). Hyperglycemia was non-significantly associated with mortality in both groups. However, the effects of dysglycemia seemed cumulative. The factors contributing to dysglycemia included disease severity, insulin treatment, glucocorticoid use, serum albumin level, total parenteral nutrition, duration of diabetes, elevated procalcitonin level, and need for mechanical ventilation and renal replacement therapy. Conclusion The association between the three dimensions of dysglycemia and mortality varied by diabetes status. Dysglycemia in critical patients is associated with excess mortality; however, glucose management in patients should be specific to the patient’s need considering the diabetes status and broader dimensions. The identified factors for dysglycemia could be used for risk assessment in glucose management requirement in critically ill patients, which may improve clinical outcomes.

Objective: To assess the application effect analysis of nurse's equipment management standardized in ICU equipment management. Method: This study included 56 related medical staffs who are working in ICU department and they used the medical equipment in their working. the data of 2018 was defined as control group, that the medical equipment was receive common management methods in 2018. In intervention group, we collected related data in 2019, that the medical equipment was receive nurse's equipment management standardized in this year, the intervention contrasts Standardize management, set up instrument management team, formulate instrument management system, instrument maintenance and repair system, instrument training system, and regularly organize study and training for all staff in the ward. We evaluated the differences between the two groups in terms of instrument repair rate, instrument maintenance cost, nursing staff's mastery of instrument and equipment skills, instrument maintenance quality, instrument and equipment maintenance rate, and instrument management mode satisfaction. Result: In terms of the frequency and cost of instrument and equipment maintenance, the frequency and cost of maintenance are both higher than the standard management, and the results are statistically significant. In the survey results of instrument and equipment standard management, except maintenance efficiency, the other data are statistically significant. The p value of nursing staff's satisfaction with instrument and equipment skills, instrument maintenance quality, instrument and equipment maintenance, the p-value instrument management mode was all less than 0.005, the difference was statistically significant. Conclusion: Standardized management of ICU equipment can reduce equipment failure rate and maintenance cost.

Authors would like to update below as article note which was missed out in original publication. The original article has been corrected.Haoming Ma and Guo Yu contributed equally to this manuscript.

No abstract

No abstract