医学
败血症
感染性休克
重症监护室
机械通风
病危
阿帕奇II
应激性高血糖
回顾性队列研究
休克(循环)
变向性
重症监护医学
内科学
胰岛素
作者
Ravindranath Tiruvoipati,Belchi Chiezey,David Lewis,Kevin Ong,Elmer Villanueva,Kavi Haji,John Botha
标识
DOI:10.1016/j.jcrc.2011.06.011
摘要
Stress hyperglycemia (SH) is commonly seen in critically ill patients. It has been shown to be associated with adverse outcomes in some groups of patients. The effects of SH on critically ill patients with sepsis have not been well studied. We aimed to evaluate the effects of SH in critically ill patients with sepsis.In this retrospective study, patients with sepsis admitted to intensive care unit (ICU) over a 5-year period were included.Of 297 patients, 204 (68.7%) had SH during the study period. The mean blood glucose level in patients with SH was 8.7 mmol/L compared with 5.9 mmol/L in those without SH (P < .05). There were no statistically significant differences in age; sex; sepsis severity; cardiovascular, respiratory, and renal comorbidities; requirement of mechanical ventilation; inotropes; and Acute Physiology, Age, and Chronic Health Evaluation III and Simplified Acute Physiology 2 scores on ICU admission. Intensive care unit mortality was significantly lower in patients who had SH. The median duration of ICU and hospital length of stay was longer in patients with SH. On logistic regression analysis, the presence of SH was associated with reduced ICU mortality. Subgroup analysis revealed SH to be protective in patients with septic shock.Stress hyperglycemia may not be harmful in critically ill patients with sepsis. Patients with SH had lower ICU mortality.
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