Incidence and Impact of Dysglycemia in Patients with Sepsis Under Moderate Glycemic Control

Fujishima, Seitaro; Gando, Satoshi; Saitoh, Daizoh; Kushimoto, Shigeki; Ogura, Hiroshi; Abe, Toshikazu; Shiraishi, Atsushi; Mayumi, Toshihiko; Sasaki, Junichi; Kotani, Joji; Takeyama, Naoshi; Tsuruta, Ryosuke; Takuma, Kiyotsugu; Yamashita, Norio; Shiraishi, Shin‐ichiro; Ikeda, Hiroto; Shiino, Yasukazu; Tarui, Takehiko; Nakada, Taka‐aki; Hifumi, Toru; Otomo, Yasuhiro; Okamoto, Kohji; Sakamoto, Yuichiro; Hagiwara, Akiyoshi; Masuno, Tomohiko; Ueyama, Masashi; Fujimi, Satoshi; Umemura, Yutaka

doi:10.1097/shk.0000000000001794

Cited by 6 publications

(4 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To our knowledge, this is the first study to explore KAP regarding glycaemic control and their influencing factors in ICU professionals in Chinese tertiary hospitals. Previous studies on glucose management in ICUs have mostly focused on the practice of glucose control, 13 complications, 18 and ICU nurses' perceptions of glucose management 19 . We, therefore, developed a KAP questionnaire for the management of blood glucose in adult ICU patients to evaluate the knowledge, attitudes and behaviours of ICU health care workers.…”

Section: Discussionmentioning

confidence: 99%

Staff knowledge, attitudes and practices regarding glycaemic management in adult intensive care units: A national survey

Huang

Yang

Zhang

et al. 2022

Nursing in Critical Care

View full text Add to dashboard Cite

BackgroundHyperglycaemia is common in critically ill adult patients. Many studies have identified the content, methods, and effects of glycaemic control but have not explored the effects of knowledge, attitudes, and practices (KAP) on glycaemic control in critically ill adults. Various factors also influence the KAP of intensive care unit (ICU) staff.AimsTo assess KAP regarding glucose management for critically ill adults among nurses and medical professionals and identify the factors that influence their KAP in ICUs.MethodsA multicentre cross‐sectional survey.ResultsIn total, 403/459 (response rate: 87.8%) participants from ICUs in nine tertiary hospitals in China participated in this study, 82.4% of whom were female and 93.4% of whom were nurses. The mean work experience was 8.88 years, and the mean critical care experience was 6.59 years. The scoring rate for the three dimensions of knowledge, attitudes, and practices were 82.35%, 87.69%, and 76%, respectively. We did not find any other factors affecting the KAP scores except for the level of knowledge awareness (p < 0.001), awareness of the importance (p < 0.001), and training for glucose control (p = 0.004).ConclusionICU staff KAP regarding glycaemic control in critically ill adults among ICU professionals were acceptable in China. However, ICU professionals' current knowledge regarding nutrition, glucose variability, and skills related to glucose management could be improved.Relevance to Clinical PracticeICU educators should provide more skills‐related training for healthcare professionals in the glycaemic management of critically ill adults. Moreover, the process of managing blood glucose in adult ICU patients is a collaborative, multidisciplinary team effort, with monitoring and feedback required during implementation.

show abstract

Section: Discussionmentioning

confidence: 99%

Staff knowledge, attitudes and practices regarding glycaemic management in adult intensive care units: A national survey

Huang

Yang

Zhang

et al. 2022

Nursing in Critical Care

View full text Add to dashboard Cite

show abstract

“…Rim et al evaluated the risk of sepsis among patients treated with different oral hypoglycemic therapies and showed that metformin, compared to meglitinides and various inhibitors (sodium-glucose cotransporter-2, alpha-glucosidase inhibitors, and dipeptidyl-peptidase 4), was associated with a lower risk of hospital admission for infection [177]. Since septic patients often show frequent variations in glycemic values, the use of a careful monitoring strategy is advisable [178].…”

Section: Insulinmentioning

confidence: 99%

2023 Update on Sepsis and Septic Shock in Adult Patients: Management in the Emergency Department

Guarino

Perna

Cesaro

et al. 2023

JCM

View full text Add to dashboard Cite

Background: Sepsis/septic shock is a life-threatening and time-dependent condition that requires timely management to reduce mortality. This review aims to update physicians with regard to the main pillars of treatment for this insidious condition. Methods: PubMed, Scopus, and EMBASE were searched from inception with special attention paid to November 2021–January 2023. Results: The management of sepsis/septic shock is challenging and involves different pathophysiological aspects, encompassing empirical antimicrobial treatment (which is promptly administered after microbial tests), fluid (crystalloids) replacement (to be established according to fluid tolerance and fluid responsiveness), and vasoactive agents (e.g., norepinephrine (NE)), which are employed to maintain mean arterial pressure above 65 mmHg and reduce the risk of fluid overload. In cases of refractory shock, vasopressin (rather than epinephrine) should be combined with NE to reach an acceptable level of pressure control. If mechanical ventilation is indicated, the tidal volume should be reduced from 10 to 6 mL/kg. Heparin is administered to prevent venous thromboembolism, and glycemic control is recommended. The efficacy of other treatments (e.g., proton-pump inhibitors, sodium bicarbonate, etc.) is largely debated, and such treatments might be used on a case-to-case basis. Conclusions: The management of sepsis/septic shock has significantly progressed in the last few years. Improving knowledge of the main therapeutic cornerstones of this challenging condition is crucial to achieve better patient outcomes.

show abstract

“…Previous studies showed that glycemic disorders may adversely affect the prognosis in patients with sepsis [ 7 , 8 ]. For example, both stress hyperglycemia and hypoglycemic events have been related to increased risk of death in patients with sepsis [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Acute glycemic variability and risk of mortality in patients with sepsis: a meta-analysis

Li¹,

Zhang

Chen³

et al. 2022

Diabetol Metab Syndr

View full text Add to dashboard Cite

Background Acute glycemic variability (GV) has been correlated with the severity of sepsis. The aim of the study was to evaluate the potential association between acute GV and mortality risk in patients with sepsis. Methods Cohort studies comparing the risk of death within 3 months between septic patients with higher versus lower acute GV were retrieved by systematic search of Medline, Embase, Web of Science, Wanfang and CNKI databases. We used a random-effect model to pool the data by incorporating the between-study heterogeneity. Sensitivity analyses were performed to evaluate the stability of the findings. Results Ten studies including 4296 patients were available for the meta-analysis. Pooled results showed that septic patients with higher acute GV had significantly increased mortality risk compared to those with lower acute GV, as evidenced by results using different parameters including standard deviation of blood glucose (SDBG, risk ratio [RR]: 1.74, 95% confidence interval [CI] 1.36–2.24, p < 0.001; I2 = 0%), coefficient of variation of blood glucose (RR: 1.91, 95% CI 1.57–2.31, p < 0.001; I2 = 0%), mean amplitude of glycemic excursion (RR: 1.81. 95% CI 1.36–2.40, p < 0.001; I2 = 0%), and glycemic lability index (RR: 2.52, 95% CI 1.72–3.68, p < 0.001; I2 = 0%). Sensitivity analyses by excluding one study at a time did not significantly affect the results (p all < 0.05). Conclusions Higher acute GV may be a predictor of mortality risk in patients with sepsis.

show abstract

Incidence and Impact of Dysglycemia in Patients with Sepsis Under Moderate Glycemic Control

Cited by 6 publications

References 35 publications

Staff knowledge, attitudes and practices regarding glycaemic management in adult intensive care units: A national survey

Staff knowledge, attitudes and practices regarding glycaemic management in adult intensive care units: A national survey

2023 Update on Sepsis and Septic Shock in Adult Patients: Management in the Emergency Department

Acute glycemic variability and risk of mortality in patients with sepsis: a meta-analysis

Contact Info

Product

Resources

About