Hyperglycemia Has a Stronger Relation with Outcome in Trauma Patients than in Other Critically Ill Patients

Vogelzang, Mathijs; Nijboer, Johanna M. M.; Horst, Iwan C. C. van der; Zijlstra, Felix; Duis, H. J. ten; Nijsten, Maarten W. N.

doi:10.1097/01.ta.0000195715.63978.80

Cited by 102 publications

(79 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is some evidence that during an acute cardiovascular event patients with hyperglycaemia have a worse prognosis than normoglycaemic patients [12,13]. The same finding has been shown after trauma [14,15]. Notably, it has been shown that type 2 diabetic patients with postprandial hyperglycaemia are at increased risk of myocardial infarction and stroke [16][17][18].…”

supporting

confidence: 58%

Acute hyperglycaemia rapidly increases arterial stiffness in young patients with type 1 diabetes

et al. 2007

View full text Add to dashboard Cite

Aims/hypothesis Augmentation index (AIx) and pulse wave velocity (PWV), both measures of arterial stiffness, constitute risk factors for cardiovascular disease. Notably, hyperglycaemia during an acute cardiovascular event is associated with poor prognosis. The objective of this study was to investigate whether acute hyperglycaemia increases arterial stiffness in patients with type 1 diabetes and in healthy subjects. Methods Twenty-two male patients with type 1 diabetes and thirteen healthy men, who were age-matched nonsmokers and without any diabetic complications, underwent a 120 min hyperglycaemic clamp (15 mmol/l). AIx was calculated to assess arterial stiffness. Before and during the clamp, carotid-radial (brachial) and carotid-femoral (aortic) PWV was measured. Results At baseline there was a difference in the AIx between patients with type 1 diabetes and healthy volunteers (−5±2.7 vs −20±2.8%, p<0.05). Acute hyperglycaemia rapidly increased AIx in patients with type 1 diabetes (−5±2.7 vs 8±2.5%, p<0.001) and healthy volunteers (−20±2.8 vs 6±8.8%, p<0.001). Brachial PWV increased during acute hyperglycaemia in patients with type 1 diabetes (7.1±1.2 vs 8.0±1.0 m/s, p<0.001), but not in healthy men (7.4±1.7 vs 7.3±1.4 m/s, NS). Conclusions/interpretation Acute hyperglycaemia increases the stiffness of intermediate-sized arteries and resistance arteries in young patients with type 1 diabetes and consequently emphasises the importance of strict daily glycaemic control. No change was observed in aortic PWV during the clamp, indicating that acute hyperglycaemia does not affect the large vessels.

show abstract

supporting

confidence: 58%

Acute hyperglycaemia rapidly increases arterial stiffness in young patients with type 1 diabetes

et al. 2007

View full text Add to dashboard Cite

show abstract

“…This finding has important implications for the clinician, since the infusion of a large volume of D5W can sometimes result in a sizable glucose load in patients for whom hyperglycemia may be detrimental (e.g., brain injury, trauma). 11 Furthermore, it is now recognized that tight control of blood glucose levels may improve outcome in critically ill patients; thus critical care physicians are trying to avoid infusing glucose when deemed unnecessary. 11,15 Although this has important clinical implications, only one study has investigated the degradation of NE in NS using HPLC.…”

Section: Discussionmentioning

confidence: 99%

“…11 Furthermore, it is now recognized that tight control of blood glucose levels may improve outcome in critically ill patients; thus critical care physicians are trying to avoid infusing glucose when deemed unnecessary. 11,15 Although this has important clinical implications, only one study has investigated the degradation of NE in NS using HPLC. Studying concentrations of 4 and 8 µg·mL -1 , Baumgartner et al, 9 found that 98% of NE was still present after 24 hr, which is in agreement with the results of our study.…”

Section: Discussionmentioning

confidence: 99%

“…This benefit would be appreciated, both in the operating room and in the intensive care unit (ICU), where a tight control of blood glucose levels has been recommended. 11,12 The primary objective of this study was to evaluate the stability of NE in D5W and NS solutions for a period of up to seven days. The secondary objective was to measure the pH of NE solutions and to assess the impact of pH on the degradation of NE.…”

Section: Ment Stables Pour Sept Jours Si Elles Sont Conservées à Tempmentioning

confidence: 99%

See 1 more Smart Citation

Stability of norepinephrine infusions prepared in dextrose and normal saline solutions

Tremblay

Lessard

Trépanier

et al. 2008

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose: Norepinephrine (NE) infusions are commonly used in the intensive care unit and in the operating room. Data on long term stability of NE solutions are lacking. This prospective study was designed to evaluate the stability of NE, in dextrose (5%) in water (D5W) and in normal saline (NS) solutions, for a period up to seven days. Methods: We prepared norepinephrine solutions in quadruplicate, by aseptically diluting 1 mg NE in 250 mL of D5W or NS and 4 mg NE in 250 mL of D5W or NS (final concentrations, 4 µg·mL -1 and 16 µg·mL -1 , respectively) and stored the solutions at room temperature under ambient light. We sampled the solutions, in duplicate, at times 0, 24, 48, 72, 120, and 168 hr and stored them at -80°C for later assay. Norepinephrine concentrations were measured by high-performance liquid chromatography with electrochemical detection (coefficient of variation 4.6%). Statistical analysis was done by nonparametric, repeated measures ANOVA (Friedman test). Results:There was no significant decrease in NE concentration for either, NE 4 µg·mL -1 in D5W or NS (P = 0.09 and 0.11, respectively) or for NE 16 µg·mL -1 in D5W or NS (P = 0.18 and 0.40, respectively). The ratios of NE concentration at 168 hr, compared to baseline, were 95.7% and 96.4%, for NE 4 µg·mL -1 in D5W and NS, respectively, and 104.5% and 96.4%, for NE 16 µg·mL -1 in D5W and NS, respectively. Conclusion: Norepinephrine solutions, in concentrations commonly used in the clinical setting, are chemically stable for seven days, at room temperature and under ambient light, when diluted either in D5W or NS. (P = 0,09 et 0,11, respectivement) ou pour la solution de NE à 16 µg·mL -1 dans du D5W ou du NS (P = 0,18 et 0,40, respectivement

show abstract

“…Next, we used the hyperglycemic index to describe multiple glucose measurements taken at irregular sampling intervals over a period of time. The index represents the mean glucose level above 108 mg/dL and yields a better estimate of overall glucose control than a single value at admission or the highest value during the day 19,20 . The hyperglycemic index was calculated for each patient in our investigation.…”

Section: Definition Of Hyperglycemiamentioning

confidence: 99%

Relationship of Hyperglycemia and Surgical-Site Infection in Orthopaedic Surgery

Richards

Kauffmann

Zuckerman

et al. 2012

The Journal of Bone & Joint Surgery

178

105

View full text Add to dashboard Cite

Hyperglycemia Has a Stronger Relation with Outcome in Trauma Patients than in Other Critically Ill Patients

Abstract: The relation of hyperglycemia and mortality is more pronounced in trauma patients than in SICU patients admitted for other reasons. The different behavior of hyperglycemia in these patients underscores the need for evaluation of intensive insulin therapy in these patients.

Cited by 102 publications

References 43 publications

Acute hyperglycaemia rapidly increases arterial stiffness in young patients with type 1 diabetes

Acute hyperglycaemia rapidly increases arterial stiffness in young patients with type 1 diabetes

Stability of norepinephrine infusions prepared in dextrose and normal saline solutions

Relationship of Hyperglycemia and Surgical-Site Infection in Orthopaedic Surgery

Contact Info

Product

Resources

About