Glucose Monitoring
The medical need for measuring glucose in the ICU/CCU
Hyperglycemia1-4, hypoglycemia1,5 and glycemic variability6-8 are independently associated with morbidity and mortality of critically ill patients. Blood glucose control with insulin has the potential to decrease morbidity and mortality of intensive care unit (ICU) patients. Blood glucose control with insulin, however, is associated with an increased risk of hypoglycemia and may not decrease glycemic variability. In addition, blood glucose control with insulin utilizing manual systems for glucose measurement is blood–consuming and time–consuming, since frequent blood draws for glucose measurements are necessary (as often as once per hour) in order to achieve blood glucose control.
The medical need for measuring glucose in the ICU/CCU
Hyperglycemia1-4, hypoglycemia1,5 and glycemic variability6-8 are independently associated with morbidity and mortality of critically ill patients. Blood glucose control with insulin has the potential to decrease morbidity and mortality of intensive care unit (ICU) patients. Blood glucose control with insulin, however, is associated with an increased risk of hypoglycemia and may not decrease glycemic variability. In addition, blood glucose control with insulin utilizing manual systems for glucose measurement is blood–consuming and time–consuming, since frequent blood draws for glucose measurements are necessary (as often as once per hour) in order to achieve blood glucose control.
- Bagshaw SM, Egi M, George C, Bellomo R. Early blood glucose control and mortality in critically ill patients in Australia.
Crit Care Med 2009:37:463-470. - Finney SJ, Zekveld C, Elia A, Evans TW. Glucose control and mortality in critically ill patients. Jama 2003:290:2041-2047.
- Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients.
Mayo Clin Proc 2003:78:1471-1478. - Falciglia M, Freyberg RW, Almenoff PL, D'Alessio DA, Render ML. Hyperglycemia-related mortality in critically ill patients varies with admission diagnosis*. Crit Care Med 2009:
- Krinsley JS, Grover A. Severe hypoglycemia in critically ill patients: risk factors and outcomes. Crit Care Med 2007:35:2262-2267.
- Krinsley JS. Glycemic variability: a strong independent predictor of mortality in critically ill patients. Crit Care Med 2008:36:3008-3013.
- Bagshaw SM, Bellomo R, Jacka MJ, Egi M, Hart GK, George C. The impact of early hypoglycemia and blood glucose variability on outcome
in critical illness. Crit Care 2009:13:R91. - Egi M, Bellomo R, Reade MC. Is reducing variability of blood glucose the real but hidden target of intensive insulin therapy?
Crit Care 2009:13:302.
