
The interest of tight glucose control in ICU is still debated. In France, no data are available regarding this therapy and the implementation of its guidelines.Sub-study of a one-day audit performed between January and May 2009.During a one-day audit performed in 66 ICUs, trained residents collected data regarding the presence of a formal glucose control protocol and its practical application.A formalized glucose control protocol was found in 88% of patients. During the day before the audit, 3645 glycemia measurements were performed accounting for six measurements [4-9] per patient with a median higher value of 1.6 [1.4-2.1]. Hypoglycemia (1.4 g/L in non-diabetic and >1.8 g/L in diabetic patients) were found in 81 (15%) and 326 (58%) patients respectively. Two episodes (0.36%) of severe hypoglycemia (<0.4 g/L) were reported. Factors associated with glucose control protocol application were: a high SOFA score, cardioversion, mechanical ventilation, intracranial pressure monitoring, steroid use and nurse to patient ratio less than 1/2.5. Hepatic failure was the only factor associated with hypoglycemia.Glucose control protocols are available in more than 80% ICUs but their implementation is still imperfect. However, the median glycemia meets international current recommendations. Severe hypoglycemia is a very rare event in ICU.
Blood Glucose, Male, Critical Care, Intracranial Pressure, Electric Countershock, Nurses, Guidelines as Topic, [MATH] Mathematics [math], Recommendations, [INFO] Computer Science [cs], Diabetes Complications, stress, intensive insulin therapy, Clinical Protocols, Glucose control, Diabetes Mellitus, Humans, Aged, glucose control, Medical Audit, critically-ill patients, Middle Aged, mortality, Hypoglycemia, Intensive Care Units, hypoglycemia, Hyperglycemia, ICU, Female, hyperglycemia, France, Liver Failure, metaanalysis
Blood Glucose, Male, Critical Care, Intracranial Pressure, Electric Countershock, Nurses, Guidelines as Topic, [MATH] Mathematics [math], Recommendations, [INFO] Computer Science [cs], Diabetes Complications, stress, intensive insulin therapy, Clinical Protocols, Glucose control, Diabetes Mellitus, Humans, Aged, glucose control, Medical Audit, critically-ill patients, Middle Aged, mortality, Hypoglycemia, Intensive Care Units, hypoglycemia, Hyperglycemia, ICU, Female, hyperglycemia, France, Liver Failure, metaanalysis
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